First Name
*
Last Name
Phone
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Email
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Could you share the specific challenges you're facing and how long they've been affecting you?
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What's holding you back from the results you want?
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Lack of Time
Lack of Motivation
Lack of Willpower and Discipline
Lack of Knowledge
Lack of Accountability
Cravings And Portion Control
Other
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On a scale from 1-5 (1 Horrible 5 Beyond Exceptional) where would you rank your BODY?
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1 - Horrible
2
3 - Average
4
5 - Beyond Exceptional
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Why did you join this group challenge?
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On a scale from 1-5 how motivated are you to experience these changes in your life?
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1 - Not Motivated
2
3 - Interested but not committed
4
5 - Extremely Motivated
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