healthhammer.com
Follow-up
Health Assessment
Privacy Policy
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Wellness Start
Follow-up
Unique ID
These questions help us provide additional support and resources based on your preferences. Your responses are optional, and we will only contact you for the options you select.
Confidentiality Notice:
Your health information is confidential, encrypted, and accessible only to you and authorized healthcare professionals. To learn more, read our
Privacy Policy
.
Preferred Contact Method
Email
Mobile/Text
I would like to…
Request my personalized report
Schedule a coaching call
Access other wellness resources
Check all options you are interested in. Additional fields will appear based on your selections.
Email Address
(Required)
Use previously provided work email
Use a different email
Preferred Email
(Required)
Mobile Number
(Required)
Other Wellness Resources
Please briefly describe your interest.
To receive your personalized report, a secure, encrypted PDF will be sent to your requested email, along with a code sent via text to your provided mobile number to open it.
After you submit this form, we will contact you to schedule your call via your preferred contact method.