Online Coaching Program
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Basic Information
What is your full name?
What is your email address?
What is your phone number?
What city are you located in?
Your Goals
What are your short term goals? 
(the more details, the better)
What are your long term goals? 
(the more details, the better)
What is the biggest problem you run into trying to hit your goals?
Why do you think coaching will help?
Is there anything else you think I should know?

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