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First & Last Name*
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Email*
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Phone*
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How did you hear about Rita Brewer?*
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What are your top health goals in the next 6 months? Be specific:*
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Do you have type 2 diabetes or Prediabetes?
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Do you have some weight you want to lose? if yes, approximately how much?
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If you could erase 3 problems related to your health, what would they be?*
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What has been your biggest struggle to reach these goals?*
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What are you MOST excited about happening if in 6 months from now you are feeling, looking, and performing better than you ever have?*
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Are you at a place in your life where you are ready to commit to your health, energy, and higher goals?*
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The investment for one individual to work with Rita Brewer for her 6 month health transformation is a four figure investment. Are you mentally and financially ready to commit to your health in this way?*
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