First Name
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Last Name
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Email
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Why are you interested in working on your health?
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Are you reaching for sugar and/or snacks daily?
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If yes, name your top 3 “grabs”...
What percentage of home cooked meals do you eat?
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Describe the kind of meals you are eating now (home and/or restaurant delivery) :
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How do your emotions affect your eating habits? Do you eat out of boredom, anger, that feeling of “not being enough”?
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What are the results you're looking for regarding your health?
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