Which media do you prefer for your 12 Fixes to Healthy book? *
Address. Please provide your mailing address below if you want a paperback book.
Your answer
I take several forms of payment. How would you like to pay? Will provide invoice with payment information or Square link for CC. May use health savings account (HSA/FSA) *
Challenge group that interests you *
Required
If other, what group interests you? *
Your answer
Do you have friends or family to you in the challenge? They may be eligible for a discount if they sign up with you. Please give their name and contact information.
Your answer
Do you have a professional or social group to do the challenge? Groups can get a further discount. *
Your answer
How you would like for me to contact you? *
Required
Do you have a discount code for the class? If so provide it below
Your answer
How did you hear about he 12 Fixes to Healthy Challenge? *
If other, how did you find me? Or list the name of the person who referred you.