Questionnaire

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What do you feel you need help with? Describe your issue. What do you feel we need to know about you to help you? *

How would you rate your physical health? (1 through 5) *

Emotional Health sad (1) vs. happy (5) *

Mental Health anxiety/brain fog (1) vs. relaxed/clarity (5) *

Spiritual Health (empty (1) vs. fulfilled (5) *

Are you ready to optimize your body-mind, your vitality and connect with the world? *

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