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Laurie Hallihan
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Questionnaire Medical History
Have you experienced events you would consider traumatic or have you suffered from abuse in the past? If yes, please consider speaking with one of the course instructors prior to enrolling in the course.
How would you describe your physical health
Excellent
Good
Fair
Poor
How would you describe your mental health?
Excellent
Good
Fair
Poor
Are you seeing a therapist/counselor currently?
Yes
No
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