CIT Intake p-1 Center For Integrative Therapy - Intake Form Please complete this form to the best of your ability. All questions are optional. Skip the question that do not apply to you Name_____________________________ - Juice fasting - Document - PDFSEARCH.IO

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	CIT Intake p-1 Center For Integrative Therapy - Intake Form Please complete this form to the best of your ability. All questions are optional. Skip the question that do not apply to you Name_____________________________ Add to Reading List Open Document File Size: 102,85 KB Share Result on Facebook Facility PLEASE DESCRIBE YOUR GOALS AND EXPECTATIONS FOR YOUR APPOINTMENT AT THE INTEGRATIVE MEDICINE CLINIC / / IndustryTerm energy level / oil / lowest energy / natural health product / food / energy / / MedicalCondition Allergy / tumor / pain / Fatigue / Cancer / Chest pain / medical conditions/illness / flu / Arthritis / Flu Shot Pneumonia / Emphysema / Cough / Bursitis / Diabetes / Asthma / / MedicalTreatment Alternative therapy / meditation / / Organization USDA / Center For Integrative Therapy / / Position Major / / Product Koss P 9 Headphone/Headset / Koss P 4 Headphone/Headset / Koss P 7 Headphone/Headset / Koss P 3 Headphone/Headset / / Technology Radiation / / SocialTag Food science Health sciences Self-care Food and drink Human nutrition Nutrition Juice Fasting Dried fruit Health

CIT Intake p-1 Center For Integrative Therapy - Intake Form Please complete this form to the best of your ability. All questions are optional. Skip the question that do not apply to you Name_____________________________Add to Reading List