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Medical Questionnaire

Please fill out the following form to help us understand your physical condition.

Have you been hospitalized in the last 12 months?
Are you currently suffering from a medical condition, illness, or injury?

Thanks for submitting!

Tel:+852 25220168 Whatsapp: +852 60805655

21/F, Canton House,

54-56 Queen’s Road Central, Central,

Hong Kong

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©2010 by Perfect Pointe Physiotherapy

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