First Name
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Last Name
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Phone Number
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Email Address
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What is your Instagram name?
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Please share your health goals with me
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What do you feel is your biggest obstacle when it comes to loving the body you are in?
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What programs and/or supplements have you tried in the past, to accomplish your health goals?
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How much money have you invested (approx) on achieving your health goals?
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After this program, you will never need to invest in another coach, product or program again, to love the body you are in. I will teach you every last thing you need to know to improve your relationship with food, movement and your body. With that being said, are you willing and able to invest financially in yourself, in order to finally reach your health goals?
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YES, I am ready to love the body I am in
NO, I am ok with everything staying exactly the same
Do you need to discuss this financial investment with your spouse/partner before moving forward?
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YES, I will need to talk to my spouse/partner before making a financial decision
NO, I can make a financial decision without discussing it with a spouse/partner
YES, I will need to talk to my spouse/partner before making a financial decision, BUT I can secure my spot in this program with a $300 USD refundable deposit in the meantime
If accepted into this program, how soon do you want to get started with my mentorship?
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Within the week
Within a couple of weeks
A month or more
Finally, what's the one thing that you love about yourself the most?
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RACQUEL WALLEN
2023
