Health questionary

Health questionnary

We will advice you the therapy to book according to your answers.

Please, share more on the next sections.
If yes, mention how many month on one of the section bellow.
Recurring pains, serious pathology, loss of a relative, major event or trauma, sensitive subject…
If uncomfortable, please details below.
If uncomfortable, please details below.

Thanks for filling the form, we will get back to you soon.

*Any informations share here are confidential and will stay between you and your body mind therapist.

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