Case Reporting Form

The Flower Essence Society has a strong commitment to promote plant research and empirical clinical research on the therapeutic effects of flower essences.

We consider ALL reports, no matter the length or source, to have validity. Flower essence practitioners wishing to make a full professional report may use our Client Intake Information and Case Evaluation forms. We are interested in careful observations detailing the changes the flower essences facilitated, the issues addressed, and how they were administered. By contributing to our research program you are helping to build a professional, collective pool of knowledge about flower essence therapy.

We are sensitive to the personal nature contained in the research information you send. We preserve strict professional anonymity of all of our case studies and testimonials unless we receive explicit permission to do otherwise. We need only to verify the case from a real person. We routinely use aliases and initials in place of real names in our research files.

We warmly invite you to join the Flower Essence Society in its ongoing research program by filling out this form. For more information about membership, click here.

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Background Information
Name:	*
Company:
Address:	*
City:	*
State/Province:		Postal Code:
Country:
Telephone:	*	Fax:
Email:	*
Professional affiliation or context for using flower essences
How did you hear about FES?

Your Report:

Please tell us your story involving the use of flower essences.

What essences were used?

How were these particular essences chosen?

What issues, qualities or particular phenomena were these essences addressing?

Please describe specifically how the essences were administered: (How many drops were used; how often were they taken; were they given under the tongue, from a dosage bottle or in drinking water, or in a different manner; how long were they administered in the particular case).

Were there any other modalities used in conjunction with the flower essences?

What effects and/or changes did you notice as a result?

When did you first notice these effects and/or changes?

Did others notice these effects and/or changes?

General Observations
about Flower Essence Therapy:

Have you perceived any trends in your healing work or noted any comments from others regarding the role of flower essence therapy?

What is your personal philosophy and belief about flower essence therapy and its role in healing?

Do you have any additional comments or questions?

Does the Flower Essence Society have permission to use what you have written?