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3-Week Group Coaching Interest Form

Want to look & feel 10 years younger after just 21 days? Fill out this short form so I can determine if you're a good fit for the program.

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3-Week Transformation Interest Form

I take on very few group coaching clients, so I can truly transform their health and longevity.

I only work with motivated, high-achieving people who have already been working on their health.

If we are a good fit to work together,  I will reach out to you.

 

Question 2 of 10

What is your biggest health challenge right now? The one thing that if solved would greatly improve your overall wellbeing?

Question 3 of 10

 

What health goal would you like to achieve that seems impossible now, but if achieved, would transform your life?

Question 4 of 10

What have you tried before to solve these problems? What worked? What did not?

Question 5 of 10

How would you describe your current lifestyle, in terms of what you do for health and longevity?

Question 6 of 10

What other challenges are you currently facing? In health, relationships, business, etc.

Question 7 of 10

What has been your single greatest frustration when it comes to your health and longevity goals?

 

Question 8 of 10

When were you at your healthiest, and what were you doing differently?

 

Question 9 of 10

First and last name

Question 10 of 10

Email

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