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Client Application
First and Last Name
Date of birth
Email
*
State/Region
Briefly list (in order of importance to you) your top 3 health goals
What is your biggest struggle/most frustrating about this?
What have you tried to do to solve this?
Why do you think you haven't been able to reach your health goals on your own?
Over the last few years, what do you estimate you've financially invested in trying to solve this on your own? (consider copays, medications, supplements, programs, time, etc)
This individualized & functional medicine approach has resulted in incredible success & health transformations for clients in as little as 4 months. Knowing it requires an emotional and financial investment, how prepared are you to taking action and financially investing in yourself to achieve your personal goals?
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