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Meet Cheryl
What is BodyIntuitive?
FAQs
Health Symptoms Addressed
COVID-19
Resources
Blog
Client Forms
Classes
Contact Us
Testimonials
Payments
Meet Cheryl
What is BodyIntuitive?
FAQs
Health Symptoms Addressed
COVID-19
Resources
Blog
Client Forms
Classes
Contact Us
Testimonials
Payments
Client Forms
COVID Intake
If you have had COVID, please answer these questions to the best of your ability:
Fisrt Name
Last Name
How many times have you had COVID?
When did you have COVID?
Did you have any of the COVID vaccines?
Which, if any, of the following symptoms did you experience? (Please also indicate if you’re still experiencing these now.)
Which, if any, of the following symptoms did you experience? (Please also indicate if you’re still experiencing these now.)
Difficulty breathing or shortness of breath
Fever
Tiredness or fatigue
Pain or “pins and needles” in: chest, stomach, joints, muscles, other
Headache
Cough
Fast-beating, pounding heart or heart palpitations
Change in smell or taste
Difficulty thinking or concentrating (“brain fog”)
Dizziness upon standing (lightheadedness)
Digestive issues (diarrhea, etc.)
Mood changes
Rash
Changes in menstrual periods
Are you still experiencing these now?
Send