Question 1 — What is your primary goal?
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A — Lose weight and keep it off
B — Recover faster and protect my body
C — More energy, focus, and mental performance
D — Slow aging and feel better long-term
E — All of the above — I want a complete transformation
Question 2 — How active are you right now?
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A — Just getting started — mostly sedentary
B — Moderately active — I exercise occasionally
C — Very active — I train regularly
D — High performer or competitive athlete
Question 3 — Have you done a physician-reviewed wellness program before?
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A — No — this would be my first time
B — Yes — I've done something similar before
C — I've done a weight management program before and want to optimize it
D — Not sure
Question 4 — What is your biggest frustration right now?
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A — I can't lose weight no matter what I try
B — I'm always tired and can't focus or stay sharp
C — My body takes forever to recover
D — I feel older than I should
E — I want to address everything at once
Question 5 — What is your commitment level?
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A — I want to test the water — show me a starter option
B — I'm serious about results — I want the best value
C — I'm all in — give me the most complete option
Email
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example@example.com
Name
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Format: (000) 000-0000.
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