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* 1. What is your age?

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* 2. What is your gender?

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* 3. What is your full name?

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* 4. Do you have any of the conditions listed below? (if so please check all that apply

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* 6. Have you noticed any "doming" in your stomach when you workout?

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* 7. In general, how would you rate your overall health?

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* 8. Do you have any other health issues you have noticed that I need to be aware of as I make my assessment?

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* 9. Do you have any tears, surgeries or previous medical surgeries I need to be aware of?

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