Medical Questionnaire

Please fill out the following form to help us understand your physical condition.

Have you been hospitalized in the last 12 months?
Are you currently suffering from a medical condition, illness, or injury?
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SIREN # 507 444 107

APE # 8690F

 Information Générale

info@hygiedietinstitute.com

Naturopathie

Nutrition Holistique

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