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1. The Basics

 
 17% of survey complete.
Note: This is a multiple-page survey. At the bottom of each page is a button marked "Next". Please click this button to move to the next page.

The information you provide will better assist me/ us in providing you with a much more personalized and enjoyable experience and will enable me / us to tailor your quality session to your own individual needs and experiences.

Thank you for taking the time to provide this valuable information.

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* 1. Name

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* 2. email address

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* 3. repeat email address

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* 4. Repeat telephone (area code) 123-4567

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* 5. telephone

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* 6. Telephone (area code) 123-4567

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* 7. Type of cell phone

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* 8. best time to call

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* 9. date of birth and/or age (I ask for your birthday as I often email special offers to my clients to help celebrate their special day)

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* 10. height

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* 11. occupation

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* 12. weight

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* 13. city in which you are requesting a session or attending a workshop

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* 14. Preferred days / times for your session

  Morning Afternoon Evening Late Night Any
Any
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

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* 15. Length of session requested

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* 16. type of session requested

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* 17. if 1-on-1 (2-handed) session, do you prefer?

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