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Please fill this form with all the details I need to know. Feel free to write as much as you want.

The more I know, the more I can help you lose weight while keeping the smallest details into consideration. 

Thank you for trusting me. 

Weight-Loss Program Registration

Please fill all the required fields.

When would you like to rest?
InBody Upload File

Please upload "Before" pictures so I can track your progress. (Optional)


Wear tight clothes. and take pictures from:

1. Front 

2. Right and Left sides

3. Back

Front image Upload File
Right side image Upload File
Left side image Upload File
Back image Upload File

You will be directed to the payment link.

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