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NAME
ADDRESS
HOME PHONE
OFFICE PHONE
E-MAIL
WEB SITE
DATE OF BIRTH
BLOOD TYPE
PRIMARY CARE PHYSICIAN
OBGYN
CHIROPRACTOR
NATUROPATH
HAIR CARE
HANDS AND FEET
BODY
GYM
 

Body Centers - Areas of Interest/Concern
Check all that apply . Your information will be stored in MyMeMap.com Profile and posted to your customized MeMap.com Home Page. You can modify your profile at any time.
CROWN
Thought / Mind / Beliefs 		Migraine
Genetic inheritance
Developmental disorders 		Spirituality
BROW
Sight / Perception / Imagination

Stroke
 Learning disabilities
Eyesight

Morality
THROAT
Sound /Connection / Creativity

Mouth ulcers
Cervical nerve pain
Cold and flu

Communications
HEART
Touch / Breath / Love 		Breast exam
High blood pressure
Asthma 		Relationships
SOLAR PLEXUS
Personal Power / Consciousness / Will 		Stomach cramps
Eating disorders
Addiction 		Self esteem
ABDOMEN
Feelings / Creativity / Desire

Pregnancy
Childbirth
 Menstruation

Sex
ROOT
Personal Safety / Trust / Belonging 		Osteoporosis
Arthritis
Chronic fatigue 		Trust

 

 

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