PHILLIPSTOWN PLAZA

 3182 Route 9 Suite 209 Cold Spring NY 10516

530 ROUTE 6, SUITE 1 MAHOPAC, NY 10541

Pro Health & Wellness

Serving Dutchess, Putnam, Orange and Westchester Counties

 3182 Route 9 Suite 209 Cold Spring NY 10516

2686 W MAIN ST, SUITE 1N WAPPINGERS FALLS, NY 12590

249 MAIN ST, UNIT 103 BEACON, NY 12508

Please answer these questions truthfully and to the best of your knowledge. This will allow us to design a treatment plan specifically designed for you. Your honest answers are greatly appreciated. If it does not apply, write N/A.

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Personal Health History

Health Habits

Family Health History

Mental Health


Men Only

Other recent problems:


Please rate each problem from a scale to 1-10, with 1 being never and 10 being often: 

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