The following is a Health Assessment administered on behalf of Christine Patterson, Independent OPTAVIA Coach. You are voluntarily filling out and submitting this form in order to help your Coach determine if OPTAVIA is the right Program for you. You are under no obligation to commit to OPTAVIA or your Coach (as an independent contractor) to maintain contact, or further communication about OPTAVIA products and services. If interested, please contact your Coach. Christine will be more than happy to assist you on your journey to health, wellness, and happiness! Most importantly, we recommend that Clients contact their healthcare provider before starting and throughout their weight loss, health, and wellness journey.