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Health Declaration

Please fill out the following form
in order to participate in our activity.

Please do note that the initial consultation service charge is posted on the treatment page this is where we can go over a general overview of what the care plan if interested can look like if client is interested in services.

Have you been hospitalized in the last 12 months?
Are you suffering from a medical or Intellectual condition, illness, or injury?

Thanks for submitting!

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