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Step 1 of 2

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Name*
Birthdate*

2. With whom do you most closely identify (select all that apply):*

3. What are the top 3 benefits you hope to get out of this program:*

4. Specifically, what are the top 2-3 things that captured your attention about the Corefirst System? (Only select 2-3)*

5. What other ways do you or would like to workout (select all that apply):*

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