Mailchimp Survey

We've all been confused and exhausted on our health and wellness journeys. It seems easy for us to gain weight year over year. This can be overwhelming when attempting it alone. Together we will focus on one thing at a time to get you closer to your goals...

First and Last Name
*
Email address
*
Send me my FREE gift now
Zip Code
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Why are you thinking about focusing on your Fitness and Nutrition?
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What is your main goal?
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What might get in the way of your goal?
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What type of fitness classes interest you?
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Cardio
Dance
Kids and Family
Low Impact
Muscle Building
Slim and Tone
Yoga
Other
How much time can you dedicate daily to fitness
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0-30 minutes31-60 minutes61-90 minutesOther
How often do you cook?
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0-3 times per week4-5 times per week6+ times per week
Do you enjoy cooking?
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0 is 0 = Not at all
10 is 10 = Love it!
012345678910
0 = Not at all
10 = Love it!
Are you currently following any type of weight loss program
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NutriSystem
Jenny Craig
Quick Weight Loss
WW (Formerly known as Weight Watchers)
Noom
Optavia
Other
Have you ever taken supplements before?
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Herbal Life
Le-Vel - Thrive
Arbonne
Shakeology
None
Other
What did you like/dislike about your previous supplement?
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Rate your excitement to work together
*
0 is Meh
10 is WHOO HOO
012345678910
Meh
WHOO HOO

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