Health Intake Form

To serve our customers better, we would like to know what your essential health needs are.

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"It's time to change our ways, to pick up the threads of knowledge that we forgot and weave them into a new kind of fabric to hold the mother. We must do it for ourselves and for our children, because the way women become mothers profoundly affects the way their children awaken to this world. When you take care of the mother, you take care of the child." – Heng Ou

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