Understanding your health.
Do you have any past or present health issues or any issues that are in your family history? (Please check all that apply to you)
If one or more of the above conditions relate to you, please provide a brief detail (e.g. surgery/doctor’s recommendation)
Do you have any pain in the following areas? (If yes, please mark the box that best describes the severity of pain that you feel)
Which of the following meals do you eat and what do you usually eat daily?
What would you like to focus on? (Check all that apply)
