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ABOUT ME
MY PHILOSOPHY
SERVICES
CONTACT
TESTIMONIALS
Mais
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Do you take any meds?
Yes
No
if yes, what?
Do you drink alcohol?
Yes
No
Drinks occasionally
Drinks alcohol regularly but moderately
if yes, how often?
Do you smoke?
Yes
No
if yes, how often?
Do you get any exercise?
Yes
No
if yes, what? how often? how long?
Are there any food allergies or intolerances that need to be considered?
Yes
No
if yes, what?
Do you currently have or have you experienced any of the following health conditions in the past?
Diabetes
Cardiovascular Disease
Dyslipidemia
Eclampsia
Gastritis
Hypertension
Hypothyroidism
Migraine
Kidney Disease
Osteoporosis
Cancer
Doesn't have any health problems
If you answered yes to any of the conditions listed above, could you please provide more details about that? Did you take any medications related to it? Is there anything else we should know about your experience with that condition?
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