Congratulations!
Welcome to the Health History form, which is the first step in bridging the gap between where you are currently and where you want to be, so kudos to you on taking this step!

There are no right or wrong answers! The form provides are starting point for me to get to know and understand you so we can accomplish more during our time together.

Not all fields are required, but please do your best to complete the form. Grab your favorite beverage, find a quiet spot, and dive in. It shouldn't take longer than about 15-20 minutes tops! Provide your first response, your gut reaction. This is important in identifying where you will begin your journey. Please note that all information provided is kept completely confidential and private.

Thank you for taking this BIG step in improving your health and well being!

Stacey

Stacey Crew Wellness Coaching
www.staceycrewcoaching.com

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