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Weight loss intake form

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The document is a Functional Weight Loss Intake Form designed for new and existing patients at Gard Wellness Center. It collects personal information, health ratings, medication history, dietary habits, and weight loss goals. The form includes sections for patient details, health assessments on a scale of 1-10, medical history inquiries, and consent for treatment. It emphasizes the importance of understanding the patient's current health status and motivations for seeking weight loss assistance.

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