Well By Court Application

Thank you so much for your interest! I have a few questions before we chat :)

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Please provide your contact info:

First Name

Last Name

Phone Number

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What are your main health complaints?

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How often do they bother you?

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How long have they been going on for?

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What have you tried so far that hasn't worked?

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How does this affect your life or what does it prevent you from doing?

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What would you expect to achieve while working with me?

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Are you willing to make diet and lifestyle adjustments as needed to help your case?

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How motivated are you on a scale from 1 to 10 to commit to getting better?

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Your application is complete. 🙌

If you're a right fit, I will reach out to schedule a call!

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