EAM Experience Questionnaire
After Completing this short questionnaire (takes 2-5 minutes) you will be directed to AJ's calendar where you'll be able to book your Zero Obligation 30 Minute Consultation Call. Click Next to Get Started!
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Have you ever invested in a high level coach, mentor or mastermind program?
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Yes
No
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What are the 3 biggest challenges you're facing in your practice right now?
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After Working With Dr. Jeremy and The EAM Team, What Are The Top 3 Things You Would Like To Have Accomplished.?
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In A Few Short Words Tell Us Why You'd Make A Great Fit For This Mastermind?
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This Mastermind is a serious investment and space is extremely limited. Please choose one of the following options that best describe you.
If accepted I’d prefer to take advantage of the special “pay in full” price of $4,997.
If accepted I’d prefer to pay over 12 months even if it means paying a higher total price.
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Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
IMPORTANT NOTE: Some browsers may block the calendar on the next page.
A calendar link can also be emailed to you. If you need assistance email support@electro-acupuncturemedicine.com
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