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How did you hear about our services?
How did you hear about our services?
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Which weight loss services are you interested in?
Medical Consultations
Meal Plans
Supplements
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What are your primary interests?
Health improvement
Increase energy levels
Enhance self-confidence
Weight Management
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Other (Please specify):
How would you rate your current level of physical activity?
How would you rate your current level of physical activity?
Sedentary (little to no physical activity)
Light (minimal activity, such as walking)
Moderate (regular exercise, such as jogging or cycling)
Vigorous (intense workouts or sports activities)
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If your goal is weight loss, what is your main goal?
Vegetarian
Vegan
Gluten-free
Dairy-free
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If other please specify:
What are your long-term health goals beyond weight loss? (check all that apply)
Improve overall fitness
Reduce risk of chronic diseases
Achieve better mental well-being
Increase longevity and quality of life
Other
List any other long-term health goals: