Please ensure this form is filled out and returned to me 7-days before our initial appointment. Failure to submit the Consent Form, Intake and Medical/Toxicology Form on time will prevent us from having a full intake appointment to allow the time necessary to review your history and medical issues you desire to address via Integrative Health Coaching. Failure to do so may result in you losing one of your appointments.
Medical Symptom/Toxicology Questionnaire
$0.00Price
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