Clarity call application
Congratulations!!!

You are ready to end your struggle with emotional eating, reach a balanced weight, and create a body and life you love!

Can't wait to talk to you!

Dina Merhbi
DinaMerhbi.com
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Email *
Last Name, First Name *
Age *
Phone number *
Which city do you live in? *
Gender *
Please share how you came to find Dina (which social media platform, Facebook group or webinar you might have attended). *
What you are currently struggling with, what has been keeping you up at night? *
How does this issue show up in your life? How does it affect your life? *
If you could wave a magic wand, what would things look like in the next 6 months? What are the results you would like to achieve? *
What are your biggest health challenges at this time? *
What investment do you have available to work with Dina so as to lead a Healthy & Wealthy life? *
How passionate are you about taking your health to the next level, and why? *
Have you worked with a registered dietitian or a health coach before? If so, how was that experience for you? *
Any additional information you'd like Dina to know prior to your call? *
Your next step
Once you complete the form, do check your inbox or junk mail folder to have access to my online schedule.

Can't wait to talk to you!

Dina Merhbi.
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