Personal information | Myokinetix Members

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Functional Performance, Health & Wellness

Perform, Function & live Pain-Free

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Sacred Sundays Community

Sacred Sundays Community

Multiple Dates

Sacred Sundays Community

When

Dec 10, 2023, 10:30 AM – 11:30 AM

Where

Palm Desert,

72205 Painters Path, Palm Desert, CA 92260, USA

Both forms must be filled in and submited

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Date of Birth

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Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

Email

My body temperature is lower than 98.6°F/ 37.5°C

I am not experiencing the symptoms: fever, cough, sore throat

I haven’t been in close contact with a Covid-19 patient in the last 14 days

Initials

Date

I declare that the info I’ve provided is accurate & complete

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Stay Connected With Us!

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Office:

72205 Painters Path,

Palm Desert, CA, 92260

© 2017 by MyoKinetix / Serene Therapeutics Rx. Proudly serving since 2007

Contact :

Tel: 760-695-4202

Email: Myokinetixhealth@gmail.com

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