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Pre-Consultation Questionnaire

  • Welcome to your initial step towards a personalized health consultation. Please take a few moments to answer the following questions. Your responses will provide valuable insights to help us better understand your health concerns and tailor our approach to your needs.

    Top Three Health Complaints

  • Successful Remedies

  • Unsuccessful Attempts

  • Current Supplements and Medications

  • Additional Information

  • Privacy and Consent

  • April 13, 2024
  • Please submit this questionnaire at least 24 hours before your scheduled appointment to allow adequate time for review.
    Thank you for taking the time to complete this questionnaire. We look forward to helping you achieve your health goals.

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Learn To Treat Yourself

Access Dr. Jess personally curated holistic medicine guides and protocols.

JOIN NOW