First Name
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Last Name
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Email
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Phone
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What are your biggest challenges with your health and overall wellness (in your mind/body/emotions)?
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What have you tried to overcome those challenges?
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Has anything you have tried been successful? Which things haven't worked well for you?
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How are your health and wellness challenges spilling over into other areas of your life?
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Are you open to learning new ways of self care (i.e. plant-based diet, inner child work, etc.)?
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How soon are you looking to make a change in your health and overall wellness?
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Is there anything that might take priority over investing in your health and self care right now?
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Would you like to receive free wellness tips to your inbox?
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