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17
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1
Email
example@example.com
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2
What is your main goal when it comes to your drinking?
Quit
Harm Reduction
Reduce
Get informed
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3
What is your #1 barrier preventing you from reducing or quitting?
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4
What are your biggest challenges with drinking?
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5
Why has what you tried not worked in the past?
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6
What has worked for you in the past?
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7
Why do you think you use alcohol?
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8
Do you have a history of childhood abuse (sexual, physical, verbal, emotional) neglect, illness, death or divorce?
YES
NO
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9
What online programs, courses or coaches have you tried in the past (if any)?
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10
How have you been feeling about your life lately?
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11
What the single biggest issue in your life right now? What are you going to do to fix it?
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12
Do you have a support system?
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13
How would nyou describe your relationship to alcohol?
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14
What, if anything, does alcohol do for you?
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15
How would you want your life to look in 6 months if you could do anything?
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16
What would support look like?
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17
What books, talks, podcasts or videos have you found to be helpful?
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