We want to hear from you! Please share your success story with us! Your story could give someone the courage, strength and motivation to commit to making a lifestyle change.
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Date *
Name *
What was your starting weight? *
What was your goal weight?
What was your ending weight? *
How long did it take you to reach your weight goal? *
If any, what benefits did you experience from this diet?
If any, what experiences were you overall happy with on the diet?
Please list any additional comments or suggestions to help make WeightMedica a better, more efficient, weight loss center,
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