FREE Spirit of Wellness Strategy Call Questionnaire
Please fill out the questionnaire and I will call you to set up a time for our call.
Full Name
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First Name
Last Name
E-mail
*
Best Phone Number
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-
Area Code
Phone Number
When is a good time for a 60 minute phone consult? Please provide 3 time ranges
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Which best describe you now? (Check all that apply)
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Vegan
Vegetarian
Semi-vegetarian
Omnivore
Would like to be vegan
Junketarian
Do you live with others? If so, please describe your household and how that affects your eating.
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If you would like to lose weight, how much would you like to lose?
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Do you have any health problems currently? Please explain.
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What kinds of stresses are getting in your way of being happy & healthy now?
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How would you like things to be different for you in 6 months?
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On a scale of 1 - 10, how important is it to you to make the changes needed to get healthier?
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1
2
3
4
5
6
7
8
9
10
Least
Most
1 is Least, 10 is Most
Thanks for filling out this questionnaire. Please click submit and you'll be notified soon about scheduling a free call.
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