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Full Name:
Email:
Phone/WhatsApp/Viber:
How Active or Labor Intensive Is Your Business/Job?:
How would you describe your health status?:
Who referred you to schedule a Health Strategy Session
What is your health targets and Goals?
What do you feel is #1 thing holding you back from your health freedom?
What other obstacles you feel are in your way in reaching your health goals and dreams?
How willing and able are you to invest in the growth of your Health, wellness and life performance right now?:
If you are accepted how soon can you get started?:
Finally, what makes you different from the other applications and why should we choose to work with you??
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"Sam is enduringly positive, yet straight and to the point. He doesn’t practice an empty encouragement made of platitudes and nice sounding words. He gives it to you straight and convinces you that your health goals are attainable; by you, by anyone."