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Please fill out the following form.
First name
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What are your current health concerns and/or goals?
What do you hope to achieve by working with me?
On a scale of 1 (not willing) to 5 (very willing), how ready are you to significantly modify your diet:
On a scale of 1 (not willing) to 5 (very willing), how ready are you to make lifestyle changes (e.g., exercise, sleep habits, work/life balance)
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