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Please fill out the form below to be added to our customer list.

 
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PAR Q
Do you feel pain in your chest when you do physical activity
yes
no
Has your doctor ever said that you have a heart condition
Yes
No
Have you developed chest pains in the last month
Yes
NO
Do you have a bone or joint problem that could be aggravated by PT
Yes
NO
Has a doctor recommended medication for blood pressure or a heart condition
Yes
No
Do you tend to lose consciousness or fall downs as result of dizziness
YES
NO
 
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