Pressotherapy Consultation Form Cryo Solihull

Name(Required)
Address(Required)
Lifestyle(Required)
Do you Smoke?(Required)
Do you follow a healthy diet?
Do you take vitamin and mineral supplements?(Required)
Are you under medical supervision at present?(Required)
Are you pregnant or could be pregnant? Please note we can not carry out this treatment due to insurance(Required)
Do you have any of the following?(Required)
Please note our cancellation policy is 48 hours - less than 48 hours full cost of the appointment will be charged.(Required)
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