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Name*

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Age*

Whom or what specifically can we thank for sending you to me?*

What is your top priority in working with me?*
soothing inflammationstriking hormone balancestimulating metabolism for permanent weight lossrenewing digestionrelieving stress/anxietysupercharging energyoptimizing sports performanceother

Have you been through Simply Nourished Like a Mother (my foundational program)?*
YesNo

Is there anything else you want me to know?

Who would you prefer to work with?
EllieJenNo Preference

Would you be open to participating in a group mentorship program?
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