Weight Loss Boot Camp Questionnaire

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Thank you for expressing interest in our Weight Loss Boot Camp designed for women looking to kickstart their 2024 weight loss goals.

We understand the unique challenges faced by women and are here to support you on your journey towards a healthier lifestyle. Kindly fill out the following questionnaire to help us tailor the boot camp to your specific needs and goals.

A member of our team will contact you to arrange a 1-to-1 consultation to discuss your responses further.
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What is your name?* This field is required.
First Name
Last Name
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What's the best email we can contact you on?* This field is required.
example@example.com
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What's the best phone number for us to reach you?* This field is required.
Area Code
Phone Number
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What is your age group?* This field is required.
25-30
31-35
36-40
41 - 45
46 - 50
51 - 55
56 and above
Other
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How motivated are you to lose weight and improve your overall health?* This field is required.Use the scale below, 1 being not motivated and 10 being extremely motivated.
1
2
3
4
5
6
7
8
9
10
Not Really Motivated
Extremely Motivated
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Have you experienced any specific challenges related to weight loss?* This field is required.Please briefly describe some of the challenges you have faced.
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Large
Normal
Small
Ok
Ok
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How would you rate your current level of physical activity?* This field is required.
Sedentary (little to no exercise)
Light (occasional walks or light workouts)
Moderate (regular exercise 2-3 times per week)
Active (regular exercise 4 or more times per week
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Are you currently following any specific diet or eating plan?* This field is required.
YESNO
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Please provide a brief description of the diet or eating plan you are following?
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Normal
Small
Ok
Ok
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What are your primary goals for joining the Weight Loss Boot Camp?Please select all that apply.
Weight loss
Increased energy levels
Improved sleep quality
Better management of perimenopause symptoms
Building strength and muscle tone
Enhancing overall wellbeing
Other
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Have you ever tried any weight loss programs or boot camps in the past?If yes, please briefly describe your experience.
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Large
Normal
Small
Ok
Ok
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How would you prefer to receive support and guidance during the boot camp?Please select all that apply.
In-person group sessions
Virtual group sessions
One-on-one coaching sessions
Online forums and support groups
Regular progress tracking and check-ins
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Would you be interested in incorporating Lemon Bottle Fat-Dissolving injections as part of your weight loss journey?
Yes, definitely
Maybe, I would like more information
No, I prefer not to include injections
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Benefits of Lemon Bottle Fat Dissolving Injections

Lemon Bottle fat dissolving injections offer several benefits that can enhance your weight loss journey and improve overall well-being. The ingredients in these injections, riboflavin, bromalein, and lecithin, have unique properties that support weight loss and promote a healthy body composition. Here are some of the benefits associated with these ingredients:

1. Riboflavin (Vitamin B2): Riboflavin plays a crucial role in energy production and metabolism. By assisting in the breakdown of carbohydrates, proteins, and fats, it helps convert food into usable energy, which can support weight loss efforts. Riboflavin also promotes healthy skin, hair, and nails.

2. Bromalein: Derived from pineapple, bromalein is a natural enzyme known for its anti-inflammatory properties. It aids in digestion, helps reduce bloating, and supports healthy gut function. Bromalein can also enhance the absorption of nutrients, contributing to overall well-being.

3. Lecithin: Lecithin is a phospholipid that helps break down fats and cholesterol, promoting their efficient metabolism and utilization by the body. It can aid in weight loss by assisting the liver in processing fats and preventing their accumulation. Lecithin also supports brain health and improves cognitive function.

Please note that while these injections may provide an additional boost to your weight loss journey, they are not a substitute for a healthy diet and regular exercise. We encourage you to consult with a healthcare professional before incorporating any new treatments or interventions.

If you have selected "Yes" or "Maybe" in your previous answer, our team will provide you with more information about lemon bottle fat dissolving injections during the Weight Loss Boot Camp orientation session.

You can also find out more about Lemon Bottle here.
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By submitting this form, you consent to receive email and/or phone communication from us regarding the Weight Loss Boot Camp and related services.
Yes, I agree
No, I don't consent
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