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Reclaim Your Health Call
Please fill out the form below so Dr. Nancy can prepare for your appointment. After you complete this form you can book a your session with her.
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1
Name
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First Name
Last Name
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2
Email
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example@example.com
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3
What is your biggest health or energy challenge right now, and how is it impacting your business or personal life?
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4
What specific results are you looking to achieve by working with me?
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5
Have you previously invested in yourself at a high level (e.g., health or business coaching, personal development)?
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YES
NO
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6
If your health and energy were fully optimized, how would that impact your business and lifestyle?
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What have you tried in the past to address these challenges, and what were the results?
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8
Why is now the right time for you to prioritize your health and business growth?
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9
On a scale of 1-10, how committed are you to making the necessary changes to achieve your goals?
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10
Are you financially prepared to invest in a premium coaching program to achieve your goals?
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No
Not sure yet
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11
Why do you believe I’m the right coach to help you?
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12
Please verify that you are human
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