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Microsoft Word - ATMAM male intake.doc
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Document Date: 2009-01-25 19:07:50

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File Size: 60,55 KB

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Company

Sex / /

MedicalCondition

sexually transmitted disease / Location_____________________________________________________ Numbness / applicable Headaches / Allergies / Constipation / back injury / bloating / Cancer / migraine / Low back pain_____ Sore heels______ Varicose Veins / Acne / Past Headaches / Traumas____________________________________________________________________________ Falls/Injuries / Taste Sciatica Trouble Sleeping Seizures Skin Disorders / /

MedicalTreatment

massage / /

NaturalFeature

Traumas____________________________________________________________________________ Falls / /

Position

Major / /

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