BodyLove Breakthru Chat
with Leah Moore | Website: leahmoorewellness.com | @leahmoorewellness
Application for free BodyLove Breakthru Chat
Please complete this form so I can best assist you in this session. After your form is reviewed, you'll receive an email with the link to schedule the chat.
Name
First Name
Last Name
Email
example@example.com
Location/Time Zone
What person, website, social media account, offering, etc. led you here?
What's the website, social media account or YouTube channel for your business, mission or art?
If applicable, what result did you get on the Body Love Blocker quiz (located at leahmoorewellness.com)?
What's the #1 health or wellness problem you must solve right away?
IN OUR SESSION, I'LL SHOW YOU HOW TO SOLVE THIS PROBLEM QUICKER
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 chat? (1 to 10)
How committed are you to resolving your health or wellness problem? (1 to 10)
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