BodyTalk Health and Wellbeing history

I do distance BodyTalk sessions. Your session details are emailed to you.

All new clients must please fill in this form prior to booking a BodyTalk session. Once the form is completed please email a picture of yourself to dawn@seaguill.co.za

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    PART 1

    * Please answer the following questions honestly and to the best of your ability.
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    PART 2

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    Family
    Relationship
    Work
    Financial
    Health
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    PART 3

    Please list areas of pain and the level of discomfort on a scale of 1 to 10: 1. Slight awareness of discomfort. 2-3. Awareness of discomfort as an aggravation. 4-6. Pain is strong but you are still functional. 7-9. Pain is so strong you are unable to function normally. 10. You feel like you need to go to the emergency room.
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    Blessings Dawn Pilatowicz dawn@seagull.co.za 083 226 8250 http://tinyurl.com/Consult1Crone Please hit SUBMIT below to send this information to my desk.