Bach Flower Questionnaire for Children

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The Original Bach Flower Remedies are a natural system of healing.

Dr. Edward Bach discovered that flowers in nature have the ability to affect our emotions positively. The energies from different flowers can remove our emotional pains and suffering, which over time harm our health and impair healing.

The Bach Flower Remedies are safe for children and are wonderful support when children are dealing with everyday fears, daydreaming, self-esteem, worries, sadness, self-acceptance, school issues, etc.

Children respond quickly to the Bach Flower Remedies because they have not had years of unresolved emotional imbalances. Parents who give Bach Flower Remedies to their children are often amazed by the positive effect the Remedies have on their children's emotional wellbeing. Screaming children find sudden relief, shy and fearful children find courage, impatient and angry children find peace and discouraged children find the will to go on.

INSTRUCTIONS

Check each statement that describes how you feel
SUBMIT Your answers
Wait for an email with the result
Select max. 7 Remedies
Make a treatment bottle
Take 4 drops, 4 times a day until you feel better

For More Information Visit www.BachFlower4Kids.com

Place an order at DirectlyFromNature.com

Date

Name

First NameLast Name

INSTRUCTIONS

1. Check each statement that describes how you feel right now or the emotions that you feel often.

AGRIMONY

I often hide my feelings behind a facade of cheerfulnessI dislike arguments and often give in to avoid conflictI turn to food or sweets when I feel upset

ASPEN

I feel anxious without knowing whyI have a strange unknown fear that something bad will happenI wake up feeling anxious

BEECH

I easily get annoyed by the habits of my parents, siblings or friendsI often focus on others peoples mistakesI often find myself being critical and intolerant of others

CENTAURY

I often neglect my own needs to please othersI find it difficult to say "NO"I tend to be easily influenced

CERATO

I constantly second-guess myselfI seek advice, mistrusting myselfI often change my mind out of confusion

CHERRY PLUM

I'm afraid I might lose control of myselfI have sudden fits of rageI feel like I'm going crazy

CHESTNUT BUD

I make the same mistakes over and overI don't learn from my experienceI keep repeating the same wrong patterns

CHICORY

I need to be needed and want my loved ones closeI feel unloved and unappreciated by my familyI easily feel slighted and hurt

CLEMATIS

I often feel spacey and daydreamingI find myself unable to concentrate for longI get drowsy and is accident prone

CRAB APPLE

I am overly concerned with cleanlinessI feel unclean or physically unattractiveI tend to obsess over little things

ELM

I feel overwhelmed by my responsibilitiesI don't cope well under pressureI have temporarily lost my self-confidence

GENTIAN

I become discouraged with small setbacksI am easily disheartened when faced with difficultiesI am often skeptical and pessimistic

GORSE

I feel hopeless, and can't see a way outI lack faith that things could get better in my lifeI feel sullen and depressed

HEATHER

I am obsessed with my own troublesI dislike being alone and I like to talkI usually bring conversations back to myself

HOLLY

I am suspicious of othersI feel discontented and unhappyI am full of jealousy, mistrust, or hate

HONEYSUCKLE

I'm often homesick when I am away from homeI miss my old school, friends or a family memberI often think about the past

HORNBEAM

I often feel too tired to face the day aheadI have no motivationI tend to put things off and may procrastinate

IMPATIENS

I find it hard to wait for thingsI am impatient and irritableI get irritated with others who are slow

LARCH

I lack self-confidenceI don't feel that I am good enoughI never expect anything but failure

MIMULUS

I am afraid of things such as spiders, crowds, etc.I am shy, overly sensitive, and modestI often get nervous and embarrassed

MUSTARD

I get sad without any reasonI feel my moods swinging back and forthI get gloomy feelings that come and go

OAK

I tend to overwork and keep on in spite of exhaustionI have a strong sense of duty and never give upI neglect my own needs in order to complete a task

OLIVE

I feel completely exhausted, physically and/or mentallyI am totally drained of all energy with no reserves leftI have just been through a long period of illness or stress

PINE

I feel unworthy and inferiorI often feel guiltyI blame myself for everything that goes wrong

RED CHESTNUT

I am overly concerned and worried about my loved onesI am distressed and disturbed by other people's problemsI worry that harm may come to those I love

ROCK ROSE

I sometimes feel terror and panicI become helpless and frozen when afraidI suffer from nightmares

ROCK WATER

I set high standards for myselfI am strict with my health, schoolwork and hobbiesI am very self-disciplined, always striving for perfection

SCLERANTHUS

I find it difficult to make decisions when I have 2 optionsI often change my opinionsI have intense mood swings

STAR OF BETHLEHEM

I feel devastated due to a recent shockI am withdrawn due to traumatic events in my lifeI have never recovered from loss, trauma or fright

SWEET CHESTNUT

I feel extreme mental or emotional heartacheI have reached the limits of my enduranceI feel complete despair, all hope gone

VERVAIN

I get high-strung and very intenseI try to convince others of my way of thinkingI am sensitive to injustice, almost fanatical

VINE

I tend to take charge of situationsI consider myself a natural leaderI am strong-willed, ambitious and often bossy

WALNUT

I am experiencing change in my life; a move, new school, etc.I get drained by people or situationsI am easily influenced by others

WATER VIOLET

I like being alone but feel lonely sometimesI prefer to be alone when overwhelmedI often don't connect with people

WHITE CHESTNUT

I have repeated unwanted thoughts and worriesI relive unhappy events or arguments over and over againI am unable to sleep at times because I can't stop thinking

WILD OAT

I can't find my path in lifeI am drifting in life and lack directionI am ambitious, but don't know what to do

WILD ROSE

I am apathetic and resigned to whatever happensI have the attitude, "It doesn't matter anyhow"I feel no joy in life

WILLOW

I feel resentful and bitterI have difficulty forgiving and forgettingI think life is unfair and have a "Poor me attitude"

RESCUE REMEDY

How to take the Remedies

Make a Bach Flower treatment bottle by adding 2 drops of each of the selected Bach Flower Remedies into a 30 ml/1 oz. mixing bottle. Combine up to 7 remedies in a treatment bottle.

As a preservative (optional) add 2 teaspoons of brandy, apple cider vinegar or vegetable glycerin.

Fill the bottle to the top with water and from this mixture take 4 drops, 4 times a day, until you feel better.

If you wake up one day feeling just a bit out of sorts, add 1-2 drops of one or more remedies into a glass of water and take small sips throughout the day until you feel better.

Rescue Remedy, a blend of five remedies, can be taken as often as needed, either by dropping 4 drops directly into the mouth, or by adding 2-4 drops in a glass of water, and drinking it slowly over a period of time.

Order remedies at DirectlyFromNature.com
or contact us at 1-800-214-2850
or info@bachflower.com

How was your experience with the questionnaire?*

Experienced Qualified Staff

The Directly From Nature & BachFlower.com staff is trained by the Bach Centre in England and our practitioners with more than 30 years of experience. We can help you and your family feel better with the help of the Bach Flower Remedies.

One on one online and telephone consultations available.

The result of the Asssessment Questionnaire will arrive shortly by email. Submit your answers now.

We are here to answer questions info@BachFlower.com

This form serves only as a suggestion. Learn more about the remedies before you take them at www.BachFlower.com and in the document that will arrive attached to your assessment result email - QuestionnaireLetter.pdf

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The Bach Flower Questionnaire for Children