Accu Weight-Loss "The Bead Diet"
all of our losers are winners
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Revlon Run/Walk
Internal Use Only
Submit Weight Loss Record to
Linda Schurter
First Name
Last Name
E-mail Address
Bead Set # (e.g., Set 1, Set 2)
Date - Day 1 of Set Being Reported (mm/dd/yy)
Weight Day 1
Weight Day 3
Weight Day 5
Weight Day 7
Weight Day 9
Comments
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Accu Weight-Loss
®
and "The Bead Diet"
®
are registered trademarks of
Accu Weight-Loss Systems, Inc. and AccuQuest Health Programs, Inc.