Let's start with getting to know you and your situation

First Name *

Last Name *

Email *

Phone *

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

What are your current goals for your relationship with food? *

What is the #1 biggest obstacle holding you back from achieving these goals on your own? *

What have you tried in the past? *

Why haven't you achieved your goals? (To the best of your knowledge) *

On a scale of 1-10, how COMMITTED are you to achieving your goals? *

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What do you want my help with over the next 2-3 months? *

I want to stop the diet-binge cycle and have a normal relationship with food On a scale of 1-10, how open to change are you?* *

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If we were to work together, on a scale of 1-10, how willing are you to taking my expert guidance and advice and implementing it? *

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If you are accepted, how soon can you get started? *

Right Away

1-2 weeks

1-2 months

3-6 months

6+ months

Financial Resources *

I Have The Financial Resources Right Now!

I Can Generate The Financial Resources

I Don't Have The Financial Resources

You have qualified to be eligible to work with me go ahead and book your call.

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