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Register Now!

Tell us a little bit about yourself.

Registration does not cost anything. We will contact you in 24 hours to discuss the best path for you.

Alternatively, you can purchase our 'Guided Consultation Package' or download our 'Starter Guide' for an immediate kick off!

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Apt, suite, etc.

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Height

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Medical Illness and Family

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List all medicines that you are currently taking (include medicines such as prescribed drugs, over-the-counter drugs, vitamins, and inhalers):

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List each of the medications that you are allergic to, and the reaction that you experienced from taking the medications:

Are you Pregnant?

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Have you got private health insurance?

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If yes, with who?

What are your health goals?

Rate your excercise

Sedentary (no excercise)

Mild excercise (climb stairs, frequent walks, golf)

Ocassional vigorous excercise(less then 3 times per week for 30 mns

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Do you drink cofee?

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If yes,

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Socially

Do you use illicit drugs?

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Yes

Sometimes

In the past

D you drink alcohol?

If yes, how much?

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Contact Us

Contact: Kimberly Miller

Address:
1b Michael Street
Brunswick, VIC 3056

Phone: 0433 300 513

Email: info@guidedhealth.com.au

Web: www.guidedhealth.com.au

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