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Wellness
I wanna know how I can help you with your wellness goals. Fill out the form and let me improve your quality of life!!!
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Email Address
Your answer
Age
Your answer
Weight
Your answer
How are you sleeping?
not much at all
1
2
3
4
5
Tons of sleep
Clear selection
How are you energy levels?
sluggish
1
2
3
4
5
super energetic
Clear selection
How often do you work out a week?
1-2 times
2-3 times
4 or more
Not at all
When I find time
Other:
Clear selection
How would you say your eating habits are?
Healthy
Vegan
Vegetarian
Not eating enough
Some healthy some not
Other:
Clear selection
How often to you eat your Greens?
Every meal
Few times a week
None Don't like them
None Don't think about it
Clear selection
What are your wellness goals?
Your answer
Anything your struggling with or want to work on wellness wise?
Your answer
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