100,000 Step Challenge

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Weekly Steps Reporting Platform
100,000 Step Challenge

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Who are you reporting steps for? *

Myself Somebody else

Please provide the name for the person you are reporting for. *

What is your email address? *

Are you reporting for Week 1, Week 2, or both? (Select all that apply) *

Week 1 Week 2 Week 3 Week 4 (+June 30)

Please select which day(s) you are reporting for (Only use for dates below): *

Saturday, June 22 Sunday, June 23 Monday, June 24 Tuesday, June 25 Wednesday, June 26 Thursday, June 27 Friday, June 28 Saturday, June 29 Sunday, June 30

Please enter the total steps for each day you are reporting separated by a comma. *

Optional --- If you wish to upload an image of your Fitbit daily accomplisments or other app you use, you may do so here. *

Max file size: 20MB

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Fairfax, VA 22031
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info@mymetromedicine.com

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