Personal Information
Full Name
Email
*
Phone
*
Your Clarifying Question
What are your top 1-2 health concerns right now?
Examples: low energy, inflammation, weight gain, erectile dysfunction, gut issues, brain fog
What have you already tried to improve your health?
Examples: diets, gym, supplements, medication, nothing yet
How long have you been experiencing these challenges?
Less than 6 months
6–12 months
1 –3 years
Over 3 years
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What do you feel is holding you back from reaching your health goals?
Lack of time
Confusion on what actually works
Lack of accountability
Poor eating habits
Stress or emotional eating
Not sure
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Are you ready to invest in a personalized wellness program if it’s the right fit?
Yes, I’m ready to invest in myself
Maybe, I need more clarity No, just exploring options
Maybe, I need more clarity
Type an Option
Type an Option
No, just exploring options
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Do you believe in a Higher Power or have a spiritual practice?
Yes, faith is important to me
Somewhat
No, but I’m open-minded
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Have you participated in any of Rashon’s programs or challenges before?
Anything you’d like Rashon to know before the call?
