REVIVE! Lifestyle Medicine Well-Being Group Coaching for Physicians -- Fall 2023 Waitlist 
Get on the waitlist to receive more information & share with your physician friends!
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Name (first and last) *
Best email *
Are you a physician? *
What is your field of medicine? *
You are *
Which medical system or practice are you/were you affiliated? *
Where is your location? *
What are your most important goals right now? *
What are your current obstacles to achieving these goals?  *
Are you interested in learning about Lifestyle Medicine to improve your health and well-being? *
Where did you hear about our coaching program? *
Is there anything else you would like to share with us?
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