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Welcome to your Weight Loss Survey
What is your Name?
Please enter your Phone Number
Do you have a weight loss goal in mind?
Yes, I'd like to lose enough weight so that my clothes fit better, or so I can wear a smaller size.
Yes, I'd like to lose a specific KG
No, I do not have a specific goal in mind
How quickly do you want to reach your goal?
Less than 30 days
Less than 60 days
It doesn't matter, as long as I can keep it off!
Do you exercise?
Yes
No
Which Food do you eat more?
Fast Food- Burger, Pizza
Healthy Food-Green Vegetables, Sprouts, Fruits
Time is Up!
Time's up
