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Medical Questionnaire

The following information is to gain a picture of your overall current health and lifestyle. Any information you give will be treated in complete confidence and will comply with General Data Protection Regulation (GDPR) requirements. Your information is sacred and would never be passed on to any outside parties.

Please fill out the following form to help us understand your physical condition.

Does your current work/lifestyle involve any of the following?
Are you currently suffering from a medical condition, illness, or injury?

Thanks for submitting!

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