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First Name:
Last Name:
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Recovery Info:
Animal you like the least:
cat
cockroach
whale
ant
snake
goldfish
tiger
horse
spider
hamster
bunny
dog
Food you like the most:
pork
chicken
banana
orange
steak
apple
lamb
potato
tomato
nuts
fish
Color you like the most:
purple
blue
turquoise
gray
pink
mauve
periwinkle
silver
brown
red
green
yellow
aquamarine
gold
no color
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