Application Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Email
example@example.com
What is your main goal?
Why is this goal important to you?
If you don´t change anything, how will your life be 1 year from now?
What are your main struggles?
For how long have you been trying to lose weight/end emotional eating?
What have you tried before? Please list anything that you have tried in the past to overcome your issues.
What worked, what didn´t work?
Fast forward 12 months from now, youve
Are you familiar with EFT (Emotional Freedom Technique, tapping)? If yes, what is your level of experience with EFT?
Where did you find us?
What would it mean to you to live a life free from yo-yo dieting and to have Food Freedom?
Submit
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