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Elite Personal Training and Fitness Solutions Health History Questionnaire

Sex
Marital Status
Present Medical History (please check off if you have had any of the prolems listed below)
Review of Systems
Family History - Has any of your family (includes parents, grandparents and siblings) ever had any of the following?
Do you smoke?
Do you drink alcoholic beverages?
BEST DAYS:
BEST TIMES:
WORST DAYS:
WORST TIMES:

Thanks for submitting!

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