contact us

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1003 Diamond Ave
South Pasadena, CA, 91030
United States


Fit-Fax Plus: Wellness Consult Form

Fit-Fax Plus Intake Form

Name *
(This will forever remain private and secure)
Heath concerns: Date of last blood draw: Fasted Glucose: Triglycerides: LDL: HDL: Other notable data:
Any family Type 2 diabetes, high blood pressure, cancer, metabolic syndrome, etc.?
Include a detailed schedule so that nutrient timing can be created.