"A New Year, A New You" Go Beyond Medicine And Transform Your Life Jan 14th 6pm-7pm

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* 1. Will you be attending?

Yes

No

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* 2. What is your name?

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* 3. What is your email address?

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* 4. Will you be bringing a guest?

Yes

No

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* 5. What is your guest's name?

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* 6. What are you hoping to gain from this workshop?