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.

* 1. First Name

* 2. Last Name

* 3. Email

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

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

* 6. What are your health goals?

* 7. What is the biggest obstacle?

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

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

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

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