Enquiry Form

1
Name* This field is required.
First Name
Last Name
2
Email address * This field is required.
example@example.com
3
Instagram/facebook handle * This field is required.(Eg, @benclaypole)
4
What is your age?* This field is required.
5
What are your biggest frustrations with weight loss, health, fitness, confidence?* This field is required.Please go deep and describe in as much detail as possible.
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6
What have you tried before to lose weight and if you are honest with yourself, why do you think it hasn't worked?* This field is required.Again, give me all the details.
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7
What would a good outcome look like to you if we are to work together over the next 6 months?* This field is required.Eg, - Lose 15kg over the next 6 months / Fit into a dress 2 sizes smaller......
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8
Do you have 90 mins per week to use our CLO Weight Loss System?* This field is required.
Yes
No
It's tight but I will find the time, its important to me
9
Assuming you and I are a good fit, are you ready to start working on your goals immediately?* This field is required.
Yes
No
Other
10
Are you ready to invest in yourself for a minimum of 16 weeks to get the results you want?* This field is required.
Yes - I am ready!
No, I thought it was free
11
What Happens Next - * This field is required.Well done, you’ve already taken the first step! The next step - which every client completes - is a short Zoom call. This call is not a test or a sales call. It’s a conversation designed to: • Ensure this mentorship truly fits your life and goals • Answer any questions you still have • Make sure you feel confident and clear before moving forward. We only bring people into the mentorship when we know it’s the right environment for them. Please book your Zoom call below. - You will be re directed after pressing SUBMIT
Let's do this!
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