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Name
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First Name
Last Name
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Email
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example@example.com
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Phone Number
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Please enter a valid phone number.
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4
Are you looking to take action on your health concerns right now OR are you looking for information?
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I'm ready to take action and start services when I find the right fit.
I do not want to start services right now, I'm just gathering more information.
I'm not sure.
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5
To reach your health goals, you will need to make some changes to your daily lifestyle habits. This may include food choices, sleep, supplements, etc. On a scale of 1 to 5, how committed are you to making these types of changes?
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5 = I'm very committed to making changes right now
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1 = I'm not committed to making changes right now
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We do not work with insurance.
We offer self-pay services. This allows us to offer more comprehensive support, without time constraints and other restrictions. Do you want to continue scheduling a discovery call?
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Yes, I'm able to pay for services myself.
Yes, I'm able to pay for services but my budget is limited.
No, currently I don't work OR I can't afford any out of pocket costs.
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7
Appointment
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By scheduling, you agree to receive email/text reminders and wellness content from us. Opt out anytime. Msg & data rates may apply.
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