Lose weight get in shape for the summer now! Only $170 a session.

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First Name:*

Last Name*

Email*

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How many pounds do you want to lose?*

Have you reached your weight loss goal in the past?*

Do you have any medical concerns or injuries? ie back problems, asthma, joint pain. etc.*

How old is the client?*

On a scale of 1 to 10, How motivated are you to lose weight?*

Have you ever been on a calorie restrictive food plan before?

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Charlie Dannelly does not guarantee weight loss results. However has never failed to help the client reach their goal.

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