Wellness Evaluation

Hello Great People! My name is Neisha Lorraine and this is The Empress Fit Journey. I am a Wellness Entrepreneur and Double Dutch Jump Rope Coach inspired to help others lead a healthy active lifestyle, eat clean, and get off the couch and get moving! While on my own Fitness journey back to health and wellness, I am here to guide you, motivate and inspire you as well as challenge you to practice self-love and self-care for YOUR OWN Fit Journey! I am the owner of MomEEJuice - All Natural and Organic Juices and I have partnered as a Health Coach with the number one nutrition company in the world, Herbalife Nutrition! I will provide one on one coaching, meal plans, workout routines along with an online accountability group designed to help you reach your goals. Please fill out the form below and I will personally reach out to you to get you started!

Full Name

First NameLast Name

Phone Number

Area CodePhone Number

Email

example@example.com

Instagram and Facebook

Age/Height/Current Weight

What are your health goals? (check all that apply)

Are you on a Fitness Regimen?

Do you skip meals?

How many times a day do you eat? (Meals and Snacks)

Do you have an Herbalife Nutrition Coach?

How much money do you spend on eating daily?

How much weight are you looking to lose or gain?

How serious are you about achieving your goal?

What is your investment level for your PERSONAL PROGRAM today?

Are you interested in joining this community?

Preferred Method of Contact

Are you also interested in learning how to make an additional part time income with Herbalife Nutrition?

Are you interested in getting a discount on your Herbalife Products?

Message Me with Additional Questions!

Wellness Evaluation

The Empress Fit Journey Wellness Evaluation