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Weight Control Program-Week 12-Post Program Weight Assessment

Last week coaching call to re-assess how the driver did and if they met their program goals.

Name(Required)
MM slash DD slash YYYY
1 star=Terrible....5 stars=Excellent
1 star=Terrible....5 stars=Excellent
1 star=Terrible....5 stars=Excellent
1 star=Terrible....5 stars=Excellent
What helped you succeed most in this program?(Required)
Choose all that apply
Would you be interested in helping us film a short motivational video to be featured solely in future Weight Control programs to help motivate drivers to stay the course in our program?(Required)
Are you willing to be featured as one of our success stories? Keep in mind, these can be done anonymously if you'd like to stay private.(Required)
What victories (large or small) did you have in this program?(Required)
Please check all that apply
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(417) 521-3473
[email protected]

2740 N Mayfair Ave, Springfield, MO, 65803

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