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Are you ready to heal your body from the inside out?
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Do you already have a doTERRA member ship?
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If so, who referred you?
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First Name
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Last Name
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Phone Number
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Email Address
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What is your top health concern?
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Please share with me a list all of your health concerns
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Please list everything you have had to eat and drink over the last 3 days
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How does your lifestyle affect your mood management and sleep?
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What is your current activity level?
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How is your mobility and physical recovery after high levels of activity?
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What are your emotional eating patterns? List all that come to mind
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How clear is your decision-making, mental focus and memory?
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What would you like to achieve in this gut health program?
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How would reaching this goal impact you and/or the people around you?
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Once you achieve your initial health goal, what would your next milestone be?
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Would you like to be added to an accountability group for additional support?
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