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About Kate
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Contact Kate
303-335-6760
Main Menu
About Kate
Classes & Schedule
Pricing
Register
Shop
Client Forms
Contact Kate
303-335-6760
About Kate
Classes & Schedule
Pricing
Register
Shop
Client Forms
Contact Kate
303-335-6760
Main Menu
About Kate
Classes & Schedule
Pricing
Register
Shop
Client Forms
Contact Kate
303-335-6760
Health History
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Health History
Name
(Required)
First
Last
Best contact phone number
(Required)
Best email
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Age
Injuries / Past / Present
(Required)
If none, type "None"
Medical Issues / Surgeries / Medications
(Required)
If none, type "None"
Current Activity Level
(Required)
Please list any chronic issues
(Required)
What other forms of treatment have you tried?
Please list any supplements you consume and why:
(Required)
Any other information you would like to share prior to your first session?
Signature
(Required)
Signature Date
MM slash DD slash YYYY
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Comments
This field is for validation purposes and should be left unchanged.
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