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Binge-free Belly Coaching with freelee
Application form
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Freelee here. I’m excited to work with you and assist you in gaining the results you dream of. Please fill in the following form so I can get to know you better.
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Email
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Your email
Name
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Your answer
Age
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Your answer
Height
*
Your answer
Weight in lbs
*
Your answer
Tell me more about your weight, whether it fluctuates or not, etc:
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Your answer
What other plans or coaching have you tried?
Your answer
How did you find Freelee?
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Instagram
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What is your Instagram page?
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Have you had any weight loss surgeries?
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NO
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If yes, which surgery?
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Are you on any medication?
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NO
If yes (Medication), which ones
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Do you exercise?
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YES
NO
If yes, what exercise, how often & for how long each week?
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