Client's, we hear you!
Take a few seconds to complete this questionnaire so that I can best cater your personal needs.
Client's Full Name
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First Name
Last Name
Phone Number
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Area Code
Phone Number
E-mail
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Birthday
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Month
-
Day
Year
Date
Preferred Method of Contact:
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Phone/Text
Email
How often would you like to receive a subscription box?
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Bi-Monthly
Quarterly
Preferred Payment Platform:
Zelle
PayPal
CashApp
Venmo
Select all categories that interest you:
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Sports Nutrition
Vitamins & Supplements
Beauty & Skincare
Personal & Body Care
Home/Green Cleaning
Select all that apply to you:
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I struggle without energy throughout the day
I struggle with falling asleep/getting good sleep
I struggle with skin sensitivity
I struggle with gut and digestion health
I want to strengthen my immune system
I want to start taking daily vitamins
I want to snack healthier and manage weight
I want to limit my exposure to toxins when cleaning/disinfecting
I love playing in makeup
I workout regularly
Check all that apply:
*
I am gluten free
I am a vegetarian
I am vegan
Anything goes
List any allegies:
Any other important information I should know to best cater to your needs?
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