Client Questionnaire Part 3 Email * Exercise Active Walking (Go out for a specific walk) * Everyday Once a week Once a month Never Running * Everyday Once a week Once a month Never Garden Work * Everyday Once a week Once a month Never Gym Workout * Everyday Once a week Once a month Never Yoga * Everyday Once a week Once a month Never Active Participation in Sports * Everyday Once a week Once a month Never Active Job i.e. Builder, Landscape Gardener etc * Yes No Lifestyle Smoking * I don't Occasionally Once a week 1 or 2 every day Heavy smoker Drinking Alcohol * I don't drink) Once a month Every week Every day Recreational Drugs * I don't Once a month Every week Every day Please list any supplements you are taking * Please list any prescriptions you are taking * Please give a brief description of your main health concern * What would you like to achieve from this consultation? * Submit Part 3
