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Unlock Your Health Potential

Unlock Your Health Potential

This form is confidential and will take 5 minutes to complete. It's designed to gauge your current health and to understand your goals. It's a starting point. That's all. After submitting, you will have the opportunity to schedule your free (no pressure or obligation) consultation to see if working together is the right fit. I'm excited to collaborate with you on your wellness journey.
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    If you don't know your current weight, please provide what you think you currently weigh.
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    Sorry men.
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    What feels out of control right now?
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    Stress management is something we will focus on if we work together.
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    This is a fun question to look back on in a few weeks after getting started!
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    This includes beverages (Starbucks, alcohol, anything that goes in your mouth).
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    Many people review their bank/credit card account to have an accurate count.
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    The average American spends over $15/day on their food and beverages.
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    If you don't currently move your body, that's OK!
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    • Outgoing
    • Reserved
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    • Task-oriented
    • People-oriented
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    HORRIBLE
    EXCELLENT
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    Thank you for sharing your insights. Together, we’ll craft a simple approach to better health. Submit this form, and we will take the next step to level up your health.

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