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Client Registration Form
Client Registration Form
Full Name
*
Email Id
*
WhatsApp No.
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Location(City & Country)
*
Age
*
Gender
*
Select
Male
Female
Prefer Not to Say
Height (in cm)
*
Weight (in Kg)
*
Your Fitness Goals
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Select
Lose Weight
Muscle Gain
Bulk
Improve Endurance
Improve Strength
Do you face any of the following?
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Select
Acidity
Bloating
Constipation
No,My digestion is fine
How did you come to know about us?
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Facebook Post
Facebook Sponsored Ad
Instagram Post
Instagram Sponsored Ad
Google
Blog Article On Fitcouplemanishka
Fitcouplemanishka's YouTube Channel
A Friend of Mine
An exsiting Fitcouplemanishka's client
Other
Have you ever used Herbalife Nutrition Before?
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Yes
No
Do you face any Joints pain(like knee pain)?
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Yes
No
Do you have a family history of Diabetes/Heart Disease?
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Select
Yes, Diabetes
Yes, Heart Disease
No
Is there any other information that you would like to share with me that would help me better coach you?
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