Please take a moment to share your thoughts with us as to how we can better serve you.  You may choose to remain anonymous.  Or, you can choose to fill in your contact information.

Regardless, we sincerely appreciate you taking the time to help us deliver exceptional service.  Thank you!

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* 1. What frustrates you the most about your health or your life right now?

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* 2. What is the #1 thing you are trying to achieve this year?

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* 3. What do you think it will take to double your health or happiness this year?

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* 4. What is it that you have already tried to do to move towards this?  What has worked or has not worked?

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* 5. Additional comments

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* 6. Your contact information (name, email, etc.)

We strive to help you reach your goals in body, mind and spirit.

Thank you for your valuable feedback!

To Your Good Health and Happiness,

Dr. John Foley and Team
Pioneer of Bioenergetic and Functional Medicine

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