Next Level Nutrition Coaching
First name
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Last name
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Email
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Confirm email
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Age
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Height
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Weight
If I/we could wave a magic wand and help you achieve 1 health, weight loss, wellness goal, what would it be?
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How will you know you’ve achieved the result you are looking for? How will achieving this outcome improve the other areas of your life?
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Have you ever been diagnosed with an eating disorder?
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Yes
No
Not diagnosed but we should talk more about this
What are you doing already to work on your health, wellness or weight loss goals? Things like how much time and money you’ve already invested in reaching your goal(s).
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If you choose to work with me, who (if anyone) do you need to talk to, in order to make the financial commitment? Please make sure you speak with them before our call.
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I make my own financial decisions
I have spoken to anyone I need to
That's a conversation I still need to have before I can invest
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