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First Name
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Last Name
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Email
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example@example.com
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4
What is your primary health goal right now?
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Boost my energy and feel lighter, fast
Relieve digestive issues (bloating, constipation, skin breakouts)
Address chronic symptoms or fatigue
Deep healing, transformation, and full-body reset
I want ongoing support and accountability
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5
How would you describe your current diet?
Mostly packaged foods or takeout
Some healthy meals, but lots of room to improve
Balanced: some fruits/veggies, cook at home, some slip-ups
Mostly plant-based or clean eating
Very clean, I juice/cleanse often
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6
Which symptoms are you experiencing now?
Select the loudest symptom you are experiencing
Low energy/fatigue
Digestive issues (constipation, gas, bloating)
Skin issues (acne, rashes, eczema)
Swelling in legs, hands or feet
Sleep problems, anxiety, or stress
None of these—I just want a reset
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7
How much experience do you have with detoxing?
Never tried a detox before
I’ve done a 1-day or 3-day cleanse/fast
I’ve done 7+ days of juicing or plant-based eating
I’ve completed a 14-day (or longer) detox
I regularly do seasonal cleanses
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8
How often do you have a daily bowel movement?
Rarely, every few days
About every other day
Once a day
2 or more times per day
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9
What best describes your commitment level to your next detox?
I need something gentle and easy to start
I’m ready to make real changes, but want guidance
I’ll do whatever it takes to get results
I want a full reset and ongoing support
I’m just curious and exploring options
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10
Calculation
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11
Hidden Score Group
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