BodyLove Breakthru Call
with Leah Moore | Website: leahmoorewellness.com | @eat2play on Instagram
Application for free 20-minute BodyLove Breakthru Call
Please complete this form so I can best assist you in our time together. After your form is reviewed, you'll receive an email with the link to schedule the call.
Name
First Name
Last Name
Email
example@example.com
Location/Time Zone
What person, website, social media account, offering, etc. led you here?
If applicable, what result did you get on the Body Love Blocker quiz (located at leahmoorewellness.com)?
What would you expect to get from working with me?
In which ways is this problem costing you TIME? (check all that apply)
Looking for health providers
Going to doctor/healer appointments
Standing in line to fill prescriptions
Figuring out the foods best for me to eat
Other
In which ways is this problem costing you CONNECTION? (check all that apply)
Missed events because of a flare up
Lack energy to do the things that light me up
Lack energy to nurture relationships
Other
In which ways is this problem costing you BODY CONFIDENCE? (check all that apply)
Lack confidence to wear what I really want
Intimacy issues with my partner
Limiting myself in anticipation of the next flare up
Ability to move my body for fun or exercise
Ability to meet physical demands of travel
Low strength to perform everyday tasks
Poor posture
Tense muscles
Insomnia
Worrying about medication side effects
Other
In which ways is this problem costing you MONEY? (check all that apply)
Missed work days
Less efficient with my work
Money spent on health practitioners/healers
Money spent on prescriptions, supplements, plant medicine or herbs
Money spent on body products or procedures
Money spent on alcohol or mind-altering substances
Other
Would you invest now to solve this problem?
No, I'm not in a place to invest.
Yes, I’m ready for expert support to solve this issue NOW and help me have the physical conditioning, energy or body I desire.
How committed are you to showing up for this call? (1 to 10)
How committed are you to showing up for this work? (1 to 10)
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