TELL ME MORE

Let’s do this thing. Together. Sustainably. In a way that makes sense not just for now, but forever.

Name

First Name

Last Name

Phone

(###)

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Current Weight

Current Height

Activity Level

Favorite Foods

What are some of your FAVORITE foods? Things that are not likely for you to want to "give up?"

Least Favorite Foods

Do you cook?

Yes!

Not so much..

I cook some of the time

Give me the rundown:

What does your average day look like? Wake up time? Bed time? Past diets? How much do you exercise? What kind of exercise? Things you have tried in the past? What worked and what did not?

Overall health:

Allergies? Illness? Medication?

What are you looking to achieve? Why?

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