Questionnaire Section

Confidence Scale Section

For the following questions, please use the Confidence Scale to rate each question from 1 to 10.  Zero (0) being NOT CONFIDENT and Ten (10) being COMPLETELY CONFIDENT

Health History

Weight Loss History

Events

Tuesday, September 2, 2014 - 12:00pm

Tuesday, September 2, 2014 - 4:15pm

Tuesday, September 2, 2014 - 4:30pm

Tuesday, September 2, 2014 - 5:30pm

Tuesday, September 2, 2014 - 6:30pm

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