MIND-BODY MEDICINE
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Welcome to the Natural Vision Family!
Together we will support our eyes optimal health and functioning and grow Holistic Eye Care as an Alternative Health Option.
Please create your Member Log In and Complete your Vision History & Goals Form.
1. Create Username & Password
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Indicates required field
Name
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First
Last
[object Object]
email
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Submit
2. Vision History Questionairre & Goals Form
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so we know who is in our Family !
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Indicates required field
Name
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Email
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How did you here about the Natural Vision Centre/School?
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Please select the Categories that represent your vision Concerns
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Myopia (Need Glasses to Drive)
I'm starting to need Drugstore Readers
I have Bifocals/Trifocals or Progressives
One of my eyes is worse than the Other
I have Lazy Eye (known clinically as Amblyopia)
I have a Degenerative Disease ie) Macular Degeneration or Retinitis pigmentosa
I have other complications. eg. Retinal Tears, Macular Pucker, Cataracts or Glaucoma,
I Struggle with Headaches and Eyestrain
I work for long hours at a Computer
In Your own words please describe your main reason for joining the Natural Vision Family. What aspect of the program is most important to you?
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What Days/Times are best for you to attend Live Q&A & Support Meetings? Please keep in mind The Natural Vision School is Mountain Standard Time.
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Weekdays
Weekends
Mornings 9 am MST
Evenings 7pm MST
Lunch Noon 12 pm MST
Days/Times that absolutely do Not work for you to attend On-Line support Calls
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Do you Wear Contacts of Glasses? If so for how many hours a day?
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Recall your life when you first noticed difficulties with your vision (including 18 months prior to needing glasses). What was going on? Had you recently moved; experienced difficulties with a teacher; changed jobs; had relationship difficulties; etc?
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At what age did you get your first pair of glasses/contacts?
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Has the eye doctor ever told you that even with lenses you do not see 20/20? in one eye
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Yes
No
Current prescription details. Please complete as you see it on your prescription form.
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How many hours a day do you spend: Outside, On Computer, Reading, Driving, T.V./ Video Games
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What factors do you notice affect your vision?
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Do you Experience any of the following: If Yes, Please Check
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Tilt your head to one side or use one eye when you read
Difficulty Night Driving
Light Sensitivity
Motion Sickness
Difficulty with Sports - coordination & catching balls
Driving and being able to assess distances between cars
What in your life do you currently find stressful? And, How do you typically deal with stress?
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What are your Vision Goals?
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Have you been diagnosed with an eye disease or complication, if so what?
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Are you currently being treated for a medical problem? If so please name what it is.
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Do you follow a Nutritional Program or restricted diet? And/or an exercise routine?
*
Submit
home
Soul-Side Out Book Download
>
Book download for Programs
Book download for Unstoppable
Tell Your Soul Story
Tell Your Soul Story CCC
Privacy
Book/Contact
About Summer
>
Single Private Sessions - Donate
Coaches
>
About Naomi
About Cayla
My Symptoms
Anxiety & Depression
Cancer & Auto-Immune
Chronic Pain, Fatigue & Fibromyalgia
Health/Life Crisis
Infections, & Skin Disorders
Lazy Eye (Amblyopia)
Migraine Headaches
Pain - Back, Knee & Shoulder
Vision Problems
>
Legal Driving Acuity
Resources
What is INside-OWT Videos
>
What is INside-OWT?
>
INside-OWT for Processing Physical Symptoms Download
10 Principles of IN-OWT
Vision Improvement Videos
>
Light Reflex
Testimonials
Video Testimonials
Classes
My Mind-Body Medicine School
Programs
Level 1 Courage to Heal
>
Investment Options
>
Investment Options Healing Mentorship
LEVEL 2 Empowered Empath Deep Dive Professional Program
>
Professional Program Payment Plans
Professional Training Videos