Pre Consultation Intake Form (Male)

Please fill in the below form prior to consultation,

IN ADDITION: During your first consultation we will be discussing your health history. In preparation for this consultation I encourage you to reflect on your health as its been for you over your life time and from birth. To think back on what health issues and interventions and significant events you have encountered over time and when they occurred. This information will be helpful in understanding what underlies your current state of health.

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