Embodied Vitality: Thrive at Any Age!
Ready to take your health to the next level? Let's get started!
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Name *
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Age *
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Occupation
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Hours worked per week
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Would you like your weight to be different?
On a scale of 1 to 10 how would you rate your stress level (one is almost no stress at all!) *
What time to you usually go to sleep? *
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On a scale of 1 to 5, how would you rate your sleep? (5 being long and uninterrupted) *
Do you experience any of the following? *
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How do you feel when you first get out of bed? Do you have energy, enthusiasm and a pep in your step? Or do you experience joint pain, stiffness, overwhelm, depression, mucus or lethargy?
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How often to you move your body and exercise? *
What is your single greatest health challenge? *
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Describe how you would like to feel physically, mentally and emotionally. What are you health goals? Dream big! *
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What are of natural health would you like to learn more about? (Check all that apply)
Thank you for you time! As a gift, I'd like to offer you a short one-on-one health coaching gym to talk about your greatest health challenge. Are you interested?
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