Your Health
Evaluation

Please fill in Your Health Evaluation

  • Date Format: DD slash MM slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Your responsibilities:

    1. To consult with a Medical Doctor or General Practitioner if you have filled one or more of the boxes before commencing a new nutritional program with Shannon Howe from I Cook You Serve.

    2. To inform your Medical Doctor or General Practitioner about the Health Evaluation and which health conditions you have checked.

    3. To talk with a Medical Doctor or General Practitioner about the kind of nutritional program you wish to commence on and to follow their advice. If my health changes so that you subsequently answer ‘’yes’’ to any of the Client Health Evaluation Ailments undertake to inform Shannon Howe immediately and to talk with a Medical Doctors or General Practitioner about the kind of nutritional program that you am on, and to follow the advice of the Medical Doctor or General Practitioner.
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