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BHealed Program Application
Full Name *
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Email Address
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Instagram Handle
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Phone Number *
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Which best describes your health history? *
How long have you been struggling with your health? *
Do you suffer from fear and anxiety related to your health?
What are your top THREE symptoms you struggle with the most currently?
Your answer
What steps are your currently taking to improve these symptoms?
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What are you top THREE goals to accomplish during this program?
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Why are you interested in this healing program?
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Are you prepared to make an investment in your health and are you committed to do the work throughout the program?
Thank you! Once Bethany has reviewed your application, you will get an email to set up an initial consultation.
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