Online Tabletomania Questionnaire

Online Tabletomania Questionnaire — the fastest way to learn about treatment options and gain insights into your medication use. Start here to take the first step toward balanced health.

Tabletomania Questionnaire

First Name

Country

Date of Birth

Phone Number

What medications do you currently take, at what daily doses, and how often?

Have you had to increase the dose over time?

What’s the longest time you’ve gone without taking these medications?

Do you have any health conditions (allergies, seizures, fainting, hallucinations, depression)?

Have you received treatment before? If so, where, how, and what were the results?

Note: