The Headache Healer’s Handbook. Jan Mundo
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chiropractor
craniosacral therapist
dentist
ENT (ear, nose, and throat doctor; or otolaryngologist)
general practitioner
healer
herbalist
homeopath
massage therapist
naturopath
neurologist
nurse practitioner
OB/GYN
occupational therapist
ophthalmologist
optometrist
orthodontist
osteopath
pain specialist
physical therapist
primary care provider
psychiatrist
psychologist
registered dietitian, nutritionist
Reiki or energy-work practitioner
social worker
other (describe): ___________________________________________
27. List headache medications taken during the past five years (prescription and over-the-counter):
MEDICATION: __________________________________________________
Dose unit (tablet/tsp/mg/ml): ______ Frequency (per day/week/month): ______
Dates taken: ____ to ____ # of years taken: ____
Still use?
Effective?
Side effects?
List side effects: ______________________________________________________
Reason(s) stopped or still using: ________________________________________
MEDICATION: __________________________________________________
Dose unit (tablet/tsp/mg/ml): ______ Frequency (per day/week/month): ______
Dates taken: ____ to ____ # of years taken: ____
Still use?
Effective?
Side effects?
List side effects: ______________________________________________________
Reason(s) stopped or still using: ________________________________________
MEDICATION: __________________________________________________
Dose unit (tablet/tsp/mg/ml): ______ Frequency (per day/week/month): ______
Dates taken: ____ to ____ # of years taken: ____
Still use?
Effective?
Side effects?
List side effects: ______________________________________________________
Reason(s) stopped or still using: ________________________________________
28. List other medications taken regularly over the past five years (for example, medication for birth control, hormone replacement, thyroid condition, blood pressure, heart condition, chronic pain, depression, sleep issues, anxiety, or sinus condition):
MEDICATION: __________________________________________________