Client Intake Form
Please enter a valid phone number.
To best serve you, Glow Body Sculpt needs a brief overview of your health. Thank you for answering our intake questions!
Do you have any of the following health issues?
Uncontrolled Blood Pressure
Congestive Heart Failure
Any recent joint injuries
Recent wounds from surgery
Metal rod or any surgical implants
Issues with blood clotting
If you answered yes to any of the above boxes, please add any additional info here. Thank you!
Are you over 18 years of age and under 65 years of age?
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