New Client Intake

What are the primary reasons you're visiting Imagine Health?

Select all that apply.

What would you most like to accomplish?

If fat loss or body composition is one of your goals, approximately how much weight would you ideally like to lose?

Optional.

What's been the biggest obstacle keeping you from getting the results you want?

Is there anything else you'd like us to know about your goals before your visit?

Optional.

Are you currently under the care of a physician or healthcare provider for an ongoing health condition?

Do you currently have, or have you previously been diagnosed with, any of the following?

Select all that apply.

Are you currently taking any prescription medications or medications/supplements that may increase sensitivity to light?

Are you pregnant or is there a possibility you may be pregnant?

Do you have any current injuries, physical limitations or areas of pain that we should know about?

Has a physician or healthcare provider ever advised you to avoid or limit exercise, heat, light-based wellness treatments or similar activities?

Is there anything else about your health that you believe Imagine Health should know before your visit?

Optional.