Health Questionnaire

Health Questionnaire

Health Questionnaire

Health Questionnaire

To assist you in your detox goals, we require that you fill in this questionnaire. All health related questions will be kept IN STRICT CONFIDENCE and we will never share this information with anyone outside Health Oasis. Please answer all fields.
What is the PURPOSE and what are your GOALS for coming to Health Oasis and doing a Detox Program?
Fasting Experience
Fasting Experience at Health Oasis
What medication are you taking?
What was the substance?
What supplement, herb, or alternative medicine are you taking?
What is the condition?

Health Oasis Resort is a project of H.E.A.L International Foundation NV Samoa

Address

Health Oasis Resort
26/4 Moo 6, Maenam
Koh Samui, Surat Thani, Thailand 84330
P: (+66) 77 602 096
E: contactus@healthoasisresort.com
W: www.healthoasisresort.com

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Health Oasis Resort is a project of H.E.A.L International Foundation NV Samoa

Address

Health Oasis Resort
26/4 Moo 6, Maenam
Koh Samui, Surat Thani, Thailand 84330
P: (+66) 77 602 096
E: contactus@healthoasisresort.com
W: www.healthoasisresort.com

Latest Post

Recent Posts

Social Media

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