Sunnyside Shift Interest Form

Let’s realign your health, energy, and purpose together.

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Email *
Name
Best Phone Number (talk/text)
Age
Gender
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Date of last physical examination
MM
/
DD
/
YYYY
Are there any chronic medical conditions?
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Current Health Concerns
Do you exercise regularly?
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What is your diet like? 
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What have you tried already?
What did you like/dislike in your prior health journey(s).
Are there any allergies?
Other Health Notes
Which best describes you right now?
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What are you currently struggling with?
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How ready are you to SHIFT?
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Is there anything else you want to share with me?
Description: “Your story, your goals, or questions—I’m here for it!”



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