Semiar questionnaire PDF 2.ready .pdf

Dr Samir Chaukkar
M.D.(Homeopathy) H.M.D.(UK)
F.B.I.H(UK),DND, P.G.Hom (London)
P.G.Addictions Treatment (Canada)

Seminar Questionnaire
Dr Samir Chaukkar, an experienced Indian Homeopath from Mumbai, who has studied and lectured
internationally will be bringing his seminars to the UK.
Potential topics that will be included in these seminars are: Sensation Method, Kingdoms,
Addiction, Autoimmune Diseases, Allergies, Skin - including Eczema, Psoriasis, Vitaligo & Acne,
Hair loss, PCOS & Infertility, Materia Medica & Differentiation, Remedy Reactions, The Second
Prescription, Clinical Tips and Case examples.
In order to ensure optimum satisfaction for all delegates he would appreciate your completion and
return of the brief questionnaire below.
All seminars would carry CPD certificates.
We thank you for your kind co-operation and look forward to seeing you in the very near future.
Warmest wishes
Dr Samir Chaukkar

1a Please circle which of the months below you could attend a
seminar in Cornwall
Jan

Feb

March

April

May

June

July

Aug

Sept

Oct

Nov

Dec

Oct

Nov

Dec

1b Please circle which of the months below you could attend a
seminar in London
Jan

2

Feb

March

May

June

Monday

Weekends

Tuesday
Saturday

Aug

Sept

Wednesday

Thursday

Sunday

Friday

Saturday & Sunday

Please circle whether you would prefer to attend
1 day seminar

4

July

Please circle when you would be able to attend a seminar

Weekdays

3

April

2 day seminar

Which of the venues below would facilitate your attendance at seminars
in Cornwall? Please circle your two choices.

Bodmin

Bude!

Launceston

Liskeard

Saltash

Truro

Please indicate below any further suggestions that you feel would enhance your
experience.

Dr. Samir Chaukkar

HollisticHealthSolutions

Please return your completed questionnaire:
Sheila Cooper, Gentle Homeopathy,
39 High Street, Delabole, Cornwall,
England PL33 9AA

sheila@gentlehomeopathy.com