Bach Remedies Questionnaire Bach Remedies Form #2Δ Notify Bach Flowers QuestionnaireThe Original Bach Flower Remedies is a natural system of healing. Dr. Edward Bach discovered that flowers in nature have the ability to affect our emotions positively. The energies from certain flowers can remove our emotional pains and suffering, which over time harm our health and impair healing.Date/FechaName/NombreSurname/ApellidoEmail/Correo electrónicoInstructions1. Tick each statement that describes how you feel2. Do not exceed 7 remedies in total3. If you exceed 7 remedies, select only the most importantAgrimony I often hide my feelings behind a façade of cheerfulness I dislike arguments and often give in to avoid conflict I turn to food , work, alcohol, drugs etc when downAspen I feel anxious without knowing why I have a strange feer that something bad will happen I wake up feeling anxiousBeech I easily get annoyed by the habits of others I often focus on other peoples mistakes I find myself being critical and intolerant of othersCentaury I often neglect my own needs to please others I find it difficult to say "no". I tend to be easily influencedCerato I constantly second-guess myself I seek advice, mistrusting my own intuition I often change my mind out of confusionCherry Plum I am afraid I might lose control of myself I have sudden fits of rage I feel like I'm going crazyChestnut Bud I make the same mistakes over and over I don't learn from my experience I keep repeating the same wrong patternsChicory I need to be needed and want my loved ones close I feel unloved and unappreciated by my family I easily feel slighted and hurtClematis I often feel spacey and absentminded I find myself unable to concentrate for long I get drowsy and sleep more than necessaryCrab Apple I am overly concerned with cleanliness I feel unclean or physically unattractive I tend to obsess over little things.Elm I feel overwhelmed by my responsibilities I don't cope under pressure I have temporarily lost my self-confidenceGentian I become discouraged by small setbacks I am easily disheartened when faced with difficulties I am often sceptical and pessimisticGorse I feel hopeless, and can't see a way out I lack faith that things could get better in my life I feel sullen and depressedHeather I am obsessed with my own troubles I dislike being alone and I like to talk I usually bring conversations back to myselfHolly I am suspicious of others I feel discontented and unhappy I am full of jealousy, mistrust and hateHoneysuckle I am often homesick for the "way it was" I think more about the past than the present I often think about what might have beenHornbeam I often feel too tired to face the day ahead I feel mentally exhausted I tend to put things off and may procrastinateImpatiens I find it hard to wait for things I am impatient and irritable I prefer to work aloneLarch I lack self-confidence I feel inferior and often become discouraged I never expect anything but failureMimulus I am afraid of things such as spiders, illness etc. I am shy, overly sensitive and modest I often get nervous and embarrassedMustard I get depressed without any reason. I feel my moods swinging back and forth I get gloomy feelings that come and goOak I tend to overwork and keep on in spite of exhaustion. I have a strong sense of duty and never give up I neglect my own needs in order to complete the taskOlive I feel completely exhausted, physically and/or mentally. I am totally drained of all energy with no reserves left I have just been through a long period of illness or stressPine I feel unworthy and inferior I often feel guilty I blame myself for everything that goes wrongRed Chestnut I am overly concerned and worried about my loved ones I am distressed and distrurbed by other people's problems I am worried that harm may come to those I loveRock Rose I sometimes feel terror and panic I become helpless and frozen when afraid I suffer from nightmaresRock Water I set high standards for myself I am strict with my health, work and/or spiritual discipline I am very self-disciplined, always striving for perfectionScleranthus I find it difficult to make decisions when I have 2 options I often change my opinions I have intense mood swingsStar of Bethlehem I feel devastated due to a recent shock I am withdrawn due to traumatic events in my life I have never recovered from loss, trauma, or frightSweet Chestnut I feel extreme mental or emotional heartache I have reached the limits of my endurance I feel complete despair, all hope is goneVervain I get high-strung and very intense I try to convince others of my way of thinking I am sensitive to injustice, almost fanaticalVine I tend to take charge of projects, situations I consider myself a natural leader I am strong-willed, ambitious and often bossyWalnut I am experiencing change in my life; a move, new job, etc. I get drained by people or situations I want to be free to follow my own ambitionsWater Violet I give the impression that I am aloof I prefer to be alone when overwhelmed I often don't connect with peopleWhite Chestnut I have repeated unwanted thoughts and worries I relive unhappy events and arguments over and over again I am unable to sleep at times because I can't stop thinkingWild Oat I can't find my path in life I am drifting in life and cant find direction I am ambitious but don't know what to doWild Rose I am apathetic and resigned to whatever happens I have the attitude " it doesn't matter anyway" I feel no joy in lifeWillow I feel resentful and bitter I have difficulty forgiving and forgetting I think life is unfair and have a "Poor me" attitudeRescue Remedy I have experienced a trauma I feel very stressed out I feel irritated and impatient I feel un-grounded and spacey I feel frightened and frozen I feel I may lose self-controlThe next step...This form serves only as a suggestion. Learn more about the remedies before you take them and follow the instructions that will arrive on the email with your questionnaire result.Submit Form
