Thank you for your interest in working with Dr. Lizette!
Please answer the following questions honestly and thoroughly to determine if you qualify for a consultation.
Upon completion, we will be with you shortly to inform you of the status of your application.
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Full Name *

 
Phone Number *

 
What's the next big step you want to take? *

 
Why do you think you haven't done it yet? *

 
What results do you want to have 3 months from now? *

Be specific.
 
On a scale of 1-10, how committed are you to do what it takes to get the results you mentioned above? *

Dr. Lizette only supports women who are decisive and determined.










 
If there is an opportunity to work with Dr. Lizette, are you currently able and ready to invest not only financially, but also your time and energy to give it your all? *

Dr. Lizette has limited spots to work with her. Please only apply if you are 110% committed to reach your goals right now.
     
 
Would you like to receive tips, special offers, and other great stuff via email from Dr. Lizette? *

     
 
Anything else you want Dr. Lizette to know?

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