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. |
Your personal Bach Remedy- Only $14.95 |
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): |
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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Is the child Withdrawn?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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