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Health Declaration Form

Any Serious illness in the last three years:
Do you have any heart, spinal, endocrine, urinary or respiratory conditions?
Do you have any indication on bones such as Osteoporosis, Arthritis or any injury or surgery in the last 3 years?
Have you had or currently have hernia?
Do you have Glaucoma?
For women, Are you currently pregnant or planning for pregnancy?

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