Elite Body Blueprint
Name
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First Name
Last Name
In a year from now, what does your elite physique look like? (Be specific as possible)
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How much progress have you made in the last month?
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What roadblocks are stopping you from reaching your dream physique?
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How is your fitness progress going
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Poorly (Little to no progress)
Struggling (Some progress but not as fast as you like)
Successful (Good progress, looking to sustain)
If you could begin making fast process towards your fitness goals, would you be interested?
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Yes
No
Maybe
Phone Number
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Instagram @
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How much do you have saved to invest in yourself (Gym, Coaching, Supplements)
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Under $100 <
$500-$1000
$1000-$1500
$1500-$2000
When are you available?
Submit
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