01787 279265 
07785 777014 


Please tell us as much as you can about your problem. When did it start? What symptoms do you have? Has it changed over time? Did anything happen which may have caused it? Is it linked to any other health issues you may have? 


Please give details of any other ongoing health issues you may have and any other medication taken 


What stresses do you have at the moment / have you had in the last few years ? Please tell us about them below. 
Is there anything else you think would be useful for us to know? 
Radionics analysis and treatment uses methods and principles which are not necessarily recognised by the medical profession. The analysis aims to discover the basic causes underlying your symptoms so appropriate treatment can be given. Like other therapies Radionics cannot claim to be successful in every case. However experience over a number of years has shown it to be helpful in a wide variety of cases. The skills of the medical profession are recognised and you may be advised to consult your doctor. You are, of course, free to consult your doctor at any time. You are asked to regularly report any changes in your symptoms and all communications with you are kept strictly confidential. Parents and Guardians are reminded that “adequate medical aid” is required by law for children under 16 years of age which in practice means that the child is registered with a doctor. 
By returning this form you are confirming that you have read and accepted this notice and would like to receive Radionics treatment (a Parent or Guardian must do this on behalf of a child under the age of 16). 
Once we have received your form electronically, we will send an e mail confirming safe receipt and the address to send your piece of hair to. It would also be helpful to have a recent photo of you but, if you don’t have one to hand, that’s fine. 
The Initial Fee of £65 is now due and may be paid by credit / debit card via our website using the buttons on our clinics and fees page or by bank transfer, details on request. 
Once the hair sample and Initial Fee have been received, the Initial Analysis will be carried out. An e mail will be sent to you with our findings together with suggestions of things you can do at home to help yourself. 
Ongoing Radionics treatment then commences on a month to month basis at a fee of £55 per month, payable monthly in advance. Where appropriate, advice will also be given of things you can do at home to help yourself. 
Treatment continues until you request that it stops. Where this occurs mid month, please note that there will be no refund of fees paid. If fees become overdue treatment will stop until payment in full is received. 
To ensure that Radionics is tailored to your particular needs, it's important that you regularly update us on how you're progressing; every 10 to 14 days is ideal. However, if there are any changes in the meantime, acute illnesses (such as Colds or Coughs) or anything else that causes you concern; please do let us know. 
Our contact details are below. Please note that we do not offer an out of hours emergency service. 
By phone 
For all phone enquiries you can call us on  
01787 279265 or 07785 777014. 
If you do go through to voicemail please leave  
us a short message and don't forget  
to include your name (!).  
By text 
You can also send us a text to  
07785 777014. 
To avoid any confusion at this end please use "plain english" - rather than text speak (!) - and remember to include your name. 
By post  
If you would like to send us a letter please let us know beforehand and we'll give you the right address! 
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