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The Wellness Programme Sign Up Form
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Email *
Name *
Phone number *
Country (If U.S please include your State) *
Please list / detail all current symptoms you’re struggling with: *
What have you tried so far? *
How would you like The Wellness Programme to help? *
What is your desired outcome / health goals? *
Can you commit for 12 weeks? *
A copy of your responses will be emailed to the address you provided.
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