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10x Your Health Breakthrough Session Application
1
Name
First Name
Last Name
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2
Email
example@example.com
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3
Phone Number
Area Code
Phone Number
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4
Tell me a little bit about your current lifestyle
Nutrition, exercise, stress levels, etc.
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5
When it comes to your health and fitness, what are your biggest challenges? What is your biggest obstacle?
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6
On a scale of 1-10, how important is it for you to get your health in order and why?
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7
Why is this so important to you?
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8
What are you currently losing/sacrificing by not having this challenge in order?
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9
Where would you like your health and fitness to be by the end of this year?
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10
What is your time zone?
You'll be contacted no later than 5 days of receiving this application to let you know whether or not you've been accepted into one of these 5 limited spots.
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