Dr. Jody's Vitality Assessment: Are You Enjoying Vital Health?

 
Congratulations! By taking this survey, you are already taking the first step towards improving your health. Your answers will help make your Complimentary Health Assessment with Dr. Stanislaw tailored to your specific needs and questions. There are 9 questions.
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1. Please list YOUR FULL NAME, EMAIL & PHONE # in the box below. WITHOUT THIS INFO, WE WILL NOT BE ABLE TO CONTACT YOU.
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2. How did you hear about the opportunity to apply for a free health assessment with Dr. Jody Stanislaw?
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