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BluePhoenix Initial Health Assessment
This evaluation will give us a baseline of where you're health is right now. We'll use this same evaluation periodically to gauge progress or new areas for improvement.
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TELL ME ABOUT YOURSELF
By learning more about you and your habits, I can take better care of you and ensure I'm coaching you in the best way for you to reach your goals.
Full Name
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Your answer
Date
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Date Of Birth
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Gender
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STAYING IN TOUCH
Let's chat, shall we?
Email
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Phone Number
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How Would You Prefer I Contact You? (check all that apply)
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