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Let’s create EXCELLENCE🔥
Excellence is not an act, but a habit! Let’s do this.🌟
12
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1
What is your name?
First Name
Last Name
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2
Phone Number
For calls and/or text messages
Please enter a valid phone number.
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3
Email
example@example.com
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4
What is your IG name?
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5
How would you like to be contacted?
Preferred method
Phone call / SMS
Email
Instagram
In person (resident Gnv, FL)
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6
If you were to pick what do you need to focus on more right now, what would it be?
To help you better!!
Lose weight
Gain healthy weight / muscle mass
Tone up / lose belly fat
Maintain weight / eat healthier
Have more energy
Better digestion
Other
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7
If other, please explain
If not, just type N/A
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8
Have you ever taken Herbalife Nutrition before?
YES
NO
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9
If so, how long ago?
1 year or less
1 - 3 years
3 - 5 years
Over 5 years
N/A
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10
Are you interested in learning how to make extra income with your results?
Yes
No
Nit right now
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11
How serious are you about starting with this journey
Very
Somehow
Relaxed
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12
How likely are you to recommend this to someone else?
Let’s help more people be happier and healthier!!
1
2
3
4
5
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