Complimentary Clarity Session Intake Form
Thank you for taking the time to fill out the following questions prior to your Total Transformation Discovery Session. All of your information will be kept confidential.

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First & Last Name *
Best Email Address *
1. What is your main area of concern? *
2. What have you done in the past to work on it? *
3. What has proven effective? *
4. What is your current diet like? Please be specific; list breakfast, lunch, dinner, and snacks, as well as the times you eat. (Please answer N/A if you're here for life coaching.) *
6. What would you like your health or life to be 30 days from now? How about 90 days from now? How would you feel if you got this result? *
7. What obstacles, challenges, and struggles do you come up with regarding diet/lifestyle? *
8. What do you hope to get out of our time together? *
9. Why are you so committed to transforming your life right now? *
10. What are 5 things you LOVE about your life? *
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