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The Bach Flowers
Remedies
were developed by Dr. Edward Bach (1886 - 1936), a Harley Street Clinic physician and prominent bacteriologist, homeopath, and researcher. Dr. Bach believed that state of mind plays a vital role in maintaining health and recovering from illness.

 
Children (under 10 years)»   Adult»  Pet»
(Moving to another questionnaire will reset this form)
Please take a few minutes to answer the following questionnaire.
For each question, select a number from 1 to 9 that corresponds to how strongly you identify with the emotions described. A 1 means that you do not experience this emotion, while a 9 means that you experience this emotion strongly.

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Up until the age of one month, the mother must be diagnosed, and the mother and infant must be given the identical essence.
This requires the mother to fill out a questionnaire about herself.
From the age of one month, an infant's personality is already apparent and s/he can be diagnosed on his or her own.
In general, regarding children, the mother should take the same essence as her child.

Children questionnaire (under 10 years):
Does s/he whine and take offense frequently?
 > > > 1  2  3  4  5  6  7  8  9  
Does the child demand constant attention?
 > > > 1  2  3  4  5  6  7  8  9  
Is the child high-strung or demanding? Does s/he want it all—now?
 > > > 1  2  3  4  5  6  7  8  9  
Does the child try to hide his or her distress and put on a face of “everything’s OK”?
 > > > 1  2  3  4  5  6  7  8  9  
Is the child Fearful?
 > > > 1  2  3  4  5  6  7  8  9  
Is the child Very quiet?
 > > > 1  2  3  4  5  6  7  8  9  
Is the child Withdrawn?
 > > > 1  2  3  4  5  6  7  8  9  
Is the child bashful?
 > > > 1  2  3  4  5  6  7  8  9  
Is s/he afraid of disappointing, or does s/he feel a need to satisfy parents or others?
 > > > 1  2  3  4  5  6  7  8  9  
Does the child feel guilty?
 > > > 1  2  3  4  5  6  7  8  9  
Does the child have trouble learning or grasping material?
 > > > 1  2  3  4  5  6  7  8  9  
Is the child depressed, sad, or ill?
 > > > 1  2  3  4  5  6  7  8  9  
Is the child far from home or family, and is homesick?
 > > > 1  2  3  4  5  6  7  8  9  
Does the child give up easily, or feel that it’s not worth trying?
 > > > 1  2  3  4  5  6  7  8  9  
Does the child suffer panic or extreme fear?
 > > > 1  2  3  4  5  6  7  8  9  
Does the child sleep an inordinate amount, yet complain of fatigue?
 > > > 1  2  3  4  5  6  7  8  9  
Was s/he born prematurely?
 > > > 1  2  3  4  5  6  7  8  9  
Is the child small or weak?
 > > > 1  2  3  4  5  6  7  8  9  
Does the child lack confidence?
 > > > 1  2  3  4  5  6  7  8  9  
Is the child a loner?
 > > > 1  2  3  4  5  6  7  8  9  
Does s/he find it difficult to deal with failure?
 > > > 1  2  3  4  5  6  7  8  9  
Is the child restless?
 > > > 1  2  3  4  5  6  7  8  9  
Does the child lay blame or always say, “It’s not fair”?
 > > > 1  2  3  4  5  6  7  8  9  
Does the child experience mood swings?
 > > > 1  2  3  4  5  6  7  8  9  
Name of child:
   
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