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* 1. My bathing suit of choice is: 

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* 2. When is the last time you wore a bikini?

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* 3. What prevents you from wearing a bikini now?

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* 4. Please enter your age

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* 5. Is there anything you'd like to tell us about bathing suits and body image? 

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* 6. Your name

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* 7. Your email address please. 

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