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Health Coaching
Prepped Meals
Meet the Community
Meet the Team
My Story
Contact
Health Coaching
Prepped Meals
Meet the Community
Meet the Team
My Story
Contact
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Your Name
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First
Last
Your Email Address
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Contact Number (Optional)
How did you hear about us?
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Google Search
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Friend Referral
Client Referral
Vendor Referral
Returning Client
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What kind of support are you interested in receiving on your healthy lifestyle journey?
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FREE 30-Minute Health Discovery Consultation
10-Step Guide
Consultation
Combination Package
Support Group - Root to Recovery
Workshop Masterclasses - Root to Recovery
Other
How soon are you prepared to embark upon your healthy lifestyle journey?
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I'm ready to create my change
I'll be ready in a few weeks
I'll be ready in the next couple of months
On a scale of 1-10, how committed are you to achieving your goals, from 1 being “Not at all” to 10 being “I’m all in!”
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1-4
5-7
8-10
When you lay awake at night and can’t sleep, what is it that’s keeping you up?
How are those stresses negatively impacting your life?
and you in
If you could wave a magic wand and time/money were no concern, what is it you most want to experience or create?
When this exists, how will it positively impact your life?
What is the maximum budget (per month) in rands that you are currently in a position to set aside to invest in rebuilding or supporting your health.
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Briefly tell me more about your top 3 lifestyle goals
Briefly tell me about your top 3 lifestyle challenges that stand between where you are right now and the lifestyle you want
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