Questionnaire for Call

Name *

First Name Last Name

Email *

example@example.com

Thank you so much for taking the time to answer a few questions in order to learn more about you.

The questions below will help us gain a better understanding of what issues you are struggling with. We take your situation very seriously and want to give you the best solution possible.

Once we receive your answers back, we will send you a call schedule request so that we can jump on a 15 minute call to see if we would be a good fit for helping you.

Thank you again for your interest in the Morph Method program,

Jake Platt, Rachel Sigl & the Morph Method Team!

What are you struggling with? *

My Weight Fitness Inflammation from health condition Mindset Injury Fatigue

What is your age? *

If you are looking to lose weight, how many pounds are you looking to want to lose? *

1-10 11-20 21-30 31 plus Other

Help me understand what your main challenge is? *

Please explain if there anything outside of your control that you believe is getting in the way of you from solving this problem? *

What efforts have you tried before to solve this problem? *

Would you consider yourself someone who is open and minded and coachable? *

Yes No Other

On a scale from 1-10, 1 being least important and 10 being most important, how important is it that you solve this problem? *

Identifying you current Mindset is crucial in solving problems. Check all that apply to what best describes your Mindset. *

Stress is the #1 reason why people are unhealthy. On a scale of 1-5 (5 being best), how would you rate your performance in your hydration? *

On a scale of 1-5 (5 being best), how would you rate your performance in your sleep? *

On a scale of 1-5 (5 being best), how would you rate your performance in your Nutrition? *

On a scale of 1-5 (5 being best), how would you rate your performance in your Exercise? *

On a scale of 1-5 (5 being best), how would you rate your performance in your Breathing? (Shortness of breath vs. Deep diaphragmatic breathing throughout day) *

What best describes you when you think about investing in your health and a weight loss/fitness program? *

I am broke and want the cheapest or as close to free as possible program out there. I am on a tight budget, but if the program is guaranteed to work I’ll find a way to sacrifice other things and spend the money, even though I am tight on funds. I know it will be an investment, but my health is a priority over everything else in my life and I have the means to make this investment. I don’t care how much your program costs. I am confident this program works and trust that it will deliver the results I dream of.

If you decide to sign up for our program, will you be able to make a decision on your own or will you need the support of someone else? If so, will your co-decision maker be able to make the call with you? *

Yes No Not applicable

One final question. We are very busy and value your time as well as our time. We ask that you set aside time to schedule this call and be free from distractions so that we can best serve you. *

Yes, absolutely! This call is very important to me and I will make this call on time or will reschedule at least 24 hours beforehand. No, I'm very busy and this call is not that important to me.

Please let us know what time zone you are in. *

Pacific Central Eastern Mountain

Thank you for filling out this questionnaire! We will reach out to schedule a 15 minute call with you! Thanks so much for your interest in MORPH Method and look forward to helping you! *

Please enter a valid phone number.

If you were referred by anyone, please put their name here. Thank You!