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Empowerment Oasis,
PLLC
Client Stress Assessment Application
Please take a moment to fill out the form.
First Name
Last Name
Email
Phone Number
Address
On a scale of 1 to 10, how would you rate your current stress level?
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Client Stress Assessment Application
Please take a moment to fill out the form.
First Name
Last Name
Email
Phone Number
Address
On a scale of 1 to 10, how would you rate your current stress level?
Do you consent to use the provided information to create a personalized stress management plan.
Yes
No
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