Section 1: About you!

Please fill out the following information:

What is your name?

What is your age?

What is your address?

Do you have any pets? *

Do you like coffee?

What is your favorite fruit?

What is your preferred method of contact?

Which of the following apply? *

When is your birthday? *

When do you usually wake up? *

When is your next appointment? *

List your drinks types today in order *

'Hot', 'Cold', etc.

What did the client enjoy today? *

How many pets do you have? *