Kijia: Let's Chat about You!
Fill out the questions below with the most honest information.
Name: *
Email Address: *
Phone Number *
Tell me about you. What habits are you trying to change? Why do you want to change them? How long have you been trying to change them?
What are your personal goals? What do you want to be different or easier for you?
Why do you think you have honestly failed in the past?
If you picture yourself in 6 months, what would you like to have changed? How will making this change make life better for you?
Are you the decision maker in attaining these goals?
Clear selection
What is your present level of commitment to address your health and reach these goals that relate to your health, nutrition, fitness and wellness?
not at all ready to change
100% committed to do what it takes
Clear selection
What are some of your favorite things?
Can't wait to connect!
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