Thank you for your interest in joining Our Health and Wellness Challenge!
I’m so excited that you’re taking this step toward your health and wellness goals. This challenge is all about resetting, renewing and recharging your mind and body so you can feel your absolute best! Your responses will help me get to know you better and personalize your experience for maximum success. Thank you for being open and willing to share—it means a lot! Let’s crush this journey together! I can’t wait to support you every step of the way! * USA and Canada Residents Only *
Name
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First Name
Last Name
Best Way to Contact You? (Share either Phone Number and or Email)
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example@example.com
Social Media Name (specify if its FB, IG, Tiktok etc)
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Please enter a valid phone number.
Format: (000) 000-0000.
What is your primary health and wellness goal for this challenge? (Examples: weight loss, increased energy, build strength, better sleep, stress reduction, etc.)
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Are there any health conditions, injuries, or dietary restrictions we should be aware of to better support you?(Examples: shoulder injury, gluten sensitivity, diabetes, etc.)
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What has been your biggest obstacle in reaching your health and weight loss goals in the past? (Examples: lack of time, consistency, cravings, stress eating, etc.)
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Do you have any dietary restrictions, food allergies, or specific preferences that we should know about to help you succeed? (Examples: gluten-free, dairy-free, nut allergies, vegetarian, etc.)
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When are you ready to get started?
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Now! I’m ready to go!
Next month would work best!
I have a few questions still.
Are you open to investing in a personalized health and wellness package to support your journey and help you reach your goals faster?
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Yes, Im ready to invest and start now!
I’m interested but would like more information.
Not at this time.
*OPTIONAL* As part of supporting your health and weight loss journey, would you be interested in our Riberbend Beef subscription bundles (never ever raised with hormones or antibiotics - sirlion steak, new york strip steak, ribeye steak, hamburgers, hotdogs, flank steaks etc...)
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Yes, that would be great
Im open to it, would love more info
No, not at this time
Submit
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