New Client Medical History Form

WORK WITH ME

Welcome i am so thrilled and excited to be working with you. Congratulations on taking the very first step into creating your own online bussiness. Here is were the magic starts encouraging you to chase your dreams and live it through this new ground breaking opportunity that has launched here in New Zealand really allows you to hit the ground running. Turning those very dreams into reailty. You have the potential to earn from wifi this allowing you to have more FREEDOM.

Joining back in October 2022 i had no expectations for this online opportunity other than to be open minded and give it a go. Today i have retired from my 9-5 job to soley dedicate my time into transforming lives. Since being in this space in such a short amount of time iv been able to watch mums be able to stay at home with their babies and live more comfortably, Hard working women become financially indepedent, Couples being able to pay off their debt, Parents being able to grow their savings faster, Families being able to take Hoildays together. Whatever your reason maybe, this bussiness allows you to be more present in your daily life.

Now Lets Start Living Your Best Life fill out the form below if you to want FREEDOM.

Full Name

First NameMiddle NameLast Name

Birth Date

DayMonthYear

E-mail

example@example.com

Mobile Phone Number

Format: (00) 00 000 000.

How did you hear about us?

What do you currently do for work ?

Where do you see yourself in the 12 months ?

What do you want your monthly income to look like ?

How much time do you have to dedicate to building your Bussiness

Where do you live ?

Best way to contact you ?