Body-Mind Goals Assessment
Email *
Please provide your first and last name. *
Let's begin by assessing your current mind and body state. Check all that apply. *
Required
Living Inspiration Tribe is about building habits for a better life. What are your desires or goals? *
Required
Describe in more detail what health or lifestyle breakthroughs you want to experience. Take a minute - please provide some context or detail. *
What is keeping you from experiencing your best self? *
Required
Are you ready to make changes to have the life you want?
Clear selection
Are you ready and able to commit time & financial resources to up-level your habits and identity?
Clear selection
How did you hear about Melinda VanKirk Wellness?
Any other details you would like to share?
How would you like to be contacted? *
Phone Number *
Almost done . . .
After you click "Submit" I will schedule a complimentary call with you to find out more. It's so much fun, and you are going to love it. I will be in touch soon!

Namaste -
Melinda
A copy of your responses will be emailed to the address you provided.
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