Welcome to the medical history form

After your first coaching session with Emmy, you can now take the time to fill out the medical history form.

It helps you better understand your migraines – and helps us provide you with targeted, individual support.

Welcome to the medical history form

After your first coaching session with Emmy, you can now take the time to fill out the medical history form.

It helps you better understand your migraines – and helps us provide you with targeted, individual support.

Step 1: Get your medical history form

Click below to save the medical history form to your computer. Then take your time to complete the form thoroughly and carefully.

Once you're done, you can skip to step 2 below and upload the form directly and securely to Emmy.

Time for you and your answers

Now, consciously take your time to fill out the form. Create a calm, comfortable atmosphere so you can record your thoughts clearly and openly.

When you are ready, come back and upload your completed form below

Step 2: Upload completed form

Please upload the completed form using the field below. Emmy will receive your file directly and securely.

Mit Emmy Verlaak auf dem Weg zur Heilung

What happens after the upload?

As soon as you submit your medical history form, Emmy will receive your answers directly.

She will carefully review your information and then email you a suggestion for your next coaching appointment if you have not yet booked it yourself.

What happens after the upload?

As soon as you submit your medical history form, Emmy will receive your answers directly.

She will carefully review your information and then email you a suggestion for your next coaching appointment if you have not yet booked it yourself.

Mit Emmy Verlaak auf dem Weg zur Heilung

Ready for the next step?

Don't want to wait for Emmy's message? Schedule your next coaching appointment right here – easy, fast, and convenient.

FAQ – Frequently Asked Questions

What happens to my data?

Your information will be treated with the utmost confidentiality. All information will be used exclusively by Emmy personally to optimally prepare your coaching sessions and tailor a personalized approach to your needs. Your data will be stored securely and never shared with third parties.

Your form will be received and read exclusively by Emmy herself. No one else will have access to it. This ensures that your answers remain confidential and protected.

After you've uploaded and submitted your form, you should schedule your next appointment with Emmy immediately. During this session, you'll discuss the contents of your medical history in detail. If you haven't booked an appointment yet, Emmy will contact you via email to remind you.

Of course! If you have any questions or technical issues while completing the form, you can contact Emmy at any time via email at welcome@migraine-transformation.com. She will help you promptly.