PMF HEALTH ASSESSMENT QUESTIONNAIRE
Please complete all sections in full so I can have the full background information of your current health status, habits and personal details. Everything is to be kept confidential.
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Email *
Full name *
Age *
Date of Birth *
MM
/
DD
/
YYYY
Weight in kg   *
Phone number *
Height in cm *
How did you hear about PMF? *
Occupation *
What is your current monthly income and what future goals do you have? I ask this question because this is a high ticket coaching package with an upfront cost and clients need to be pre-qualified so I maintain a quality service . *
What is your location ? *
Activity level at work ? *
Almost no movement & seated all day
Hard labour everyday
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