| Document Date: 2013-06-06 08:29:31
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Facility Vita Integrative Health Clinic / / IndustryTerm similar device / / MedicalCondition ankles Poor circulation Stroke / Skin Allergy / Arthritis / haemophilia / pain / Indigestion Stomach Pain/Ulcer/Hernia Nausea/Vomiting / Moderate Severe Emphysema Difficulty breathing Colds / Flu / Allergies / Difficult digestion Constipation Diarrhea Liver/Gall Bladder Kidney/Bladder Diabetes / Injury / TB / Epilepsy Cancer / HIV / Digestive / Urogenital High blood pressure Low blood pressure Chronic / mental illness / osteoporosis / / MedicalTreatment Massage Therapy / Surgery / massage / / Position therapist / massage therapist / /
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Vita Integrative Health Clinic - Massage Therapy Health History Form The information requested below will assist us in treating you safely. Feel free to ask any questions about the information being requested. Please not