The Reflux Relief Group Program The time is now to take control of your health & find lasting symptom relief. Email * Please confirm your email once more. * Please ensure your email is spelled correctly :) Name * First Name Last Name Phone * (###) ### #### How did you hear about FLORA Nutrition? * Where are you located? And what is your time zone? * What is your current age? * What do you feel are your biggest barriers to achieving Reflux Relief? * Why do you want to join the FLORA Reflux Relief Program? Why NOW? * What medical diagnosis/diagnoses are you currently navigating? * Please briefly describe your health concerns/symptoms, when they began, and how long they have persisted. * What programs/treatments/supplements/diets/lifestyle changes have you tried to resolve your symptoms? * Have they been successful? Have you ever worked with a dietitian or nutritionist before? If so, please describe your experience. * The investment of the Reflux Relief Group Program is $1495 paid in full (or two payments of $775, 3 payments of $525). This includes access to the FLORA Method Reflux Relief Modules, Weekly Group Coaching with Molly (12 sessions), 1yr membership to the FLORA App, weekly message check-ins w/ Molly, a 1:1 Session with Molly (Fast action bonus by 1/3: you will receive an additional 1:1 call w/ Molly) and more (>$7k value!). Does this investment work for you at this time? * Yes, I'm ready to invest in my health No, not at this time The Reflux Relief Program is currently accepting new 1:1 clients who are ready to commit to their health/wellbeing to create longterm change and REAL results. Do you feel ready to commit to your health and apply personalized, sustainable recommendations to your nutrition/lifestyle? * Yes, I'm ready to get results! No, not at this time Are you open to creating a brief video testimonial after the progam? * Yes! No Are you willing to write a written testimonial after the program? * Yes! No I understand that the Reflux Relief Group Coaching calls program kick off on in January and this works for me! I also understand that if I’m unable to attend the live sessions (not a problem!), I can watch the replays later and still stay on track. Plus, I can submit any questions or comments in advance for the group calls, ensuring I still get the support I need even if I can't join live. * Yes, got it! I have more questions. To help inspire and encourage others, we love to celebrate new participants in our Reflux Relief Group Program! Would you be comfortable allowing us to share your first name in our marketing materials to announce that you've joined the program? * Yes, I give permission to use my first name in marketing materials. No, I do not give permission. We will reach out to you via email with next steps. Check your spam or email info@flora-nutrition.com if you don't hear from us! Please feel free to write here any Questions you have or anything else you'd like us to know. * We look forward to connecting with you! Thank you!
