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1
Email
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example@example.com
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2
Name
*
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First Name
Last Name
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3
Which type of body movement do you prefer?
*
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Yoga
Dance
Weights
MMA
Gym
Cardio
Mixed
Walking
Other
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4
How would you prioritize these?
*
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Not a Priority
Some Priority
High Priority
Routine
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Nutrition
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Community
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Row 2, Column 1
Row 2, Column 2
Yourself
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
GUT HEALTH
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Row 4, Column 1
Row 4, Column 2
Routine
Nutrition
Community
Yourself
GUT HEALTH
Not a Priority
Row 0, Column 0
Some Priority
Row 0, Column 1
High Priority
Row 0, Column 2
Not a Priority
Row 1, Column 0
Some Priority
Row 1, Column 1
High Priority
Row 1, Column 2
Not a Priority
Row 2, Column 0
Some Priority
Row 2, Column 1
High Priority
Row 2, Column 2
Not a Priority
Row 3, Column 0
Some Priority
Row 3, Column 1
High Priority
Row 3, Column 2
Not a Priority
Row 4, Column 0
Some Priority
Row 4, Column 1
High Priority
Row 4, Column 2
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5
How would you like to connect, one-on-one, to find out what works best for you so we can customize it to your NEEDS
*
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Email
Zoom
Messenger
Phone Chat
I'm not ready to talk about that yet
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6
Goals
*
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Check all that apply
Loose Weight
Build Muscle
Build Routine
Learn how to build a sustainable, healthy lifestyle
Connect with other people that want to live life by design, too
Learn how to navigate cookouts and Social Events
Lead my family with BETTER CHOICES
Reset and balance my GUT- hormones, bloat, and figure out general food frustrations/ sensitivities.
Other
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7
How would you describe your eating habits
*
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Trash Panda, let me dust the hot Cheetos off of my fingers to answer this
Clean eats, my body is my temple
Somewhere between the two
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8
How often do you want to move your body in the name of Richard Simmons
*
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less than 30 min a day
Everyday
more than 30 min each day
3-5 times a week
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9
Do you want to learn how to cocktail or eat at the BBQ without regret?
The answer is yes, unless of course the answer is no. Nothing is off limits is what I'm getting at. Lets get ready to PARTY!!
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