Health Survey First Name Email Last Name Phone Neck Pain Low Back Pain HeadachesStressed SHopulders Mid Back PainScoliosisAuto Accident Numbness in HandsPoor PostureMuscle Spasm Sports Injury Loss of Energy Stomach IssuesADD/ADHDPhysical StressJoint PainArthritisWrist PainArm PainLeg/Hip Pain Other: please list any other health concerns you have. Remember… Your Health Outcomes Are Based On Your Health Choices! Please hand the iPad back to one of our assistants for your free health assessment. DO NOT CONTINUE PAST THIS POINT Employee*Hunter SammyHannahMorganMarcBryantSaidieHunter Romny Screening *Home and Garden Show Payson Cinco De Mayo Mothers Day Expo Spanish Fork Health Fair Payson Adventure Days Submit
