How long have you been struggling with your weight or body image?

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* 1. How long have you been struggling with your weight or body image?

What are the specific challenges you’re dealing with?

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* 2. What are the specific challenges you’re dealing with?

What effect is a negative body image or extra weight having on your life now?

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* 3. What effect is a negative body image or extra weight having on your life now?

If you don’t resolve it, what will the long-term costs be to you?

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* 4. If you don’t resolve it, what will the long-term costs be to you?

Do you believe that your negative body emotion is contributing to a weight and/or food problem?

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* 5. Do you believe that your negative body emotion is contributing to a weight and/or food problem?

Please tell me how you found my website.

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* 6. Please tell me how you found my website.

Thank-you for your responses! Please provide your email address, phone number and your time zone and I'll be in touch to schedule your Complimentary Body Image Breakthrough Session!

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* 7. Thank-you for your responses! Please provide your email address, phone number and your time zone and I'll be in touch to schedule your Complimentary Body Image Breakthrough Session!

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