Erika B Online Inquiry 
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First Name
Last Name
Cell Phone Number *
Email *
Address *
Age *
Height *
Weight *
Desired Weight *
Primary Goal
Are there any health concerns I should know about? *
Do you have any pain? (knees, hips, back, etc.) and scale 1-10 what is that pain
What is a typical daily diet for you? Have you ever tracked calories or macros? *
When was the last time you were in the best shape of your life? Going back to that time, how did you feel?
*
What is the biggest limitation in the past to seeing the results you wanted?                                              examples: time, money, knowledge, motivation
*
Are you looking for workouts created for your gym or home? *
Best times to reach you *
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