I'd love to chat. Would you answer a few quick questions so I can better serve you?

Thank you for answering these questions. I'll reach out to you to schedule a call as soon as I receive your responses.

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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. What's the best phone number to reach you?

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* 5. What's going on with your health?

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* 6. What are your health goals?

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* 7. What is the biggest obstacle?

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* 8. What types of diets and/or services have you tried? (i.e., Weight Watchers, Paleo, Cleanses, Colonics, GI Specialist)

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* 9. How committed are you on a level of 1 to 10, 10 being very committed?

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* 10. Is there anything else you want me to know?

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