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Interest Form
As I offer a personal service where I will be in direct daily contact with you, places are extremely limited. Please complete the form with as much detail as possible. I will then be in touch to discuss further.
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Name
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Email Address
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Age
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Place of Residence
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What are your biggest challenges right now with your health and weight loss goals?
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What specifically do you want to achieve whilst working with me?
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What is your Instagram Name (optional)
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One final thing – where did you hear about my coaching practice?
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Thank you for your interest. I will be in touch to discuss further within the next 24-48 hours.
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