What is NuCalm® Therapy?

+357 99236991
hello@neuroreflexcyprus.com
Mon-Fr: 09:00-17:00

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Creating your personalized path to healing starts here.
Please complete this form with as much detail as possible. This ensures your first session is fully
tailored to your body’s unique needs and goals.

First Name *

Last Name *

Email Address *

Contact Phone *

Gender *

Date of birth *

Country & City *

Occupation *

Presenting Concerns

1. What are your primary health concerns or goals?(e.g., chronic pain, fatigue, muscle weakness, mobility, neurological issues, emotional wellbeing)

2. When did these issues begin?(Please describe the progression or any key changes over time.)

3. Have you received a formal diagnosis?If yes, please specify

4. What treatments or therapies have you tried so far?(Include medications, physiotherapy, alternative therapies, etc.)

Medical History

Please check any conditions you have (past or present):Neurological Disorders (e.g., MD, MS, ALS)Autoimmune ConditionsChronic Pain or InflammationCardiovascular Issues (high/low blood pressure, heart disease)Respiratory ConditionsSkin Conditions (eczema, psoriasis)Mental Health (anxiety, depression, trauma)Endocrine or Hormonal DisordersDigestive Issues (IBS, reflux, etc.)Sleep Disorders (insomnia, apnea)Cancer (past or present)Infectious Diseases (incl. COVID/post-COVID symptoms)Known Parasites or Pathogens (if tested)

Medications & Supplements

Are you currently taking any medications or supplements? *If yes, please list them and their purposes

Do you have any known allergies (medications, herbs, foods)? *If yes, please explain

Contraindications & Sensitivities

Do you have:A pacemaker or implantable electronic device?Epilepsy or seizure history?Sensitivity to light or photosensitivity (Photobiomodulation)?Severe mental health instability (NuCalm contraindication)?Pregnancy or trying to conceive?History of heart arrhythmia or uncontrolled blood pressure?

Lifestyle & Emotional Health

How would you describe your energy level on most days? *(Scale of 1–10)

Do you practice any mindfulness, breathwork, or movement practices? *If yes, please share:

How would you rate your stress level? *LowModerateHighChronic

What is your sleep like? *(Difficulty falling asleep, staying asleep, fatigue upon waking?)

Optional Upload

You may upload any recent medical records, lab results, MRIs, or diagnostic reports to help us better understand your case.

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Is there anything else you would like us to know before we begin?

Consent & Agreement *

By submitting this form, you agree that the information provided is true to the best of your knowledge. You understand that these therapies are complementary in nature and do not replace medical diagnosis or emergency care.

Working Hours

If you have specific needs or require an appointment outside our regular hours, please don’t hesitate to reach out.

Mon – Fri: 09:00 – 17:00

Sat – Sun: Closed

Appointments

The clinic works with preliminary appointments.
Please make yours here.

Make an appointment here

Reach Out Today

Email

hello@neuroreflexcyprus.com

Phone

+357 99236991

Open Hours

Mon-Fri: 09:00 - 17:00
Sat-Sun: Closed

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By purchasing any package or service from Neuro Reflex Clinic, you agree to the following:

All purchases are final and non-refundable. Please make sure you’re ready before completing your purchase.
Packages are for personal use only and cannot be transferred unless stated otherwise.
Any sessions or services included must be used within the agreed time period. Unused sessions will expire.
If you need to reschedule a session, please do so at least 24 hours in advance. Late cancellations or no-shows may be counted as used.
Results vary and depend on your personal effort and commitment. No specific outcomes are guaranteed.
All content and materials provided are for your use only and may not be shared or redistributed.

By completing your purchase, you confirm that you’ve read and agreed to these terms.