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How old are you?
Under 30
30 - 39
40 - 49
50 - 59
Over 60
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How many pounds do you want to lose?
10 lbs or less
11-50 lbs
51-100 lbs
101-200 lbs
Over 200 lbs
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How long have you been trying to lose weight?
Less than 1 month
1-12 months
Over 1 year
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Why do you want Ultimate Sirt Juice?
(Select all that apply.)
I want more energy
I want to fit in my clothes better
I want to feel more confident
I want to feel younger
I want to live a nutritional lifestyle
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How do you feel about enjoying this one tasty drink to help you achieve your weight loss goal?
How do you feel about enjoying this one tasty drink
to help you achieve your weight loss goal?
Nervous. I’ve struggled before, but I feel optimistic.
I love this! It sounds so easy.
Seems doable... Ready to tackle this challenge.
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