Wellness Readiness Questionnaire

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A journey of thousand miles starts with a single step! Fill out this Wellness Readiness Questionnaire to find out if you ready to embark on your health and wellness journey.

Email *

Name *

Phone number

Now tell me a little bit about yourself. Goals you need help with (choose all that apply) *

lose weight

increase energy levels

improve digestion

strengthen immune system

improve sleep quality

balance hormones

balance blood sugar

slow down aging

eliminate food cravings

reduce food sensitivities or intolerances

Required

Any other goals not listed above?

What have you tried before to achieve your goals? What were the results? *

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