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* 1. Hi All! Kindly provide your name & Email address for selection of the free 30min ‘Discover Me’ wellness assessment session on completion. Thank you for taking our survey.

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* 2. What is your profession?

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* 3. What is your greatest health challenge?

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* 4. How would you rate your health from 1-10 (10 =Excellent)

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* 5. What are your health and wellness goals in the next 3 months?

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* 6. Do you have any chronic conditions?

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* 7. Do you follow a healthy routine ? (Exercise, Meditation, Yoga)

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* 8. How would you like to feel in the best version of yourself?

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* 9. Have you been diagnosed with Anxiety or Depression? ( please tell me more)

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* 10. Would you like to receive free offers health advice and wellness tips from Dr Kirasha Allopi (Yes/No)

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