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Who's This?
Quick Facts About You
To make a lifestyle change, I don't have enough (Choose Any)
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Time
Money
Internal Motivation
Social Support
None of the above
Do you currently attend a gym and/or invest in personal training?
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Yes
No
How much do you spend on your groceries per month (1 Person)?
*
Less than $100
$100 - $200
$200 - $300
$300 - $400
Over $400
Are you...
*
Single, No Children
Single, With Children
Married, No Children
Married, With Children
Divorced, No Children
Divorced, With Children
Widowed, No Children
Widowed, With Children
What is your age?
*
Less than 18
18-25
26-34
35-45
45-59
60 or higher
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