Healthy Dynamic Life Success System Application

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What is your name?* This field is required.
First Name
Last Name
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What is your best e-mail address?* This field is required.
example@example.com
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What is your phone number?* This field is required.
Country Code
Area Code
Phone Number
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Where do you currently reside?* This field is required.
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What timezone are you in right now?
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How did you learn about this opportunity to release unwanted excess weight in the quickest, easiest, healthiest, and most enjoyable way possible?* This field is required.
I watched the webinar.
I clicked on the link in an email.
I clicked on the link from Instagram.
I heard about it in the Facebook Group Eat Your Way to Weight Loss
A friend referred me
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Which of the following best describes your lifestyle?* This field is required.
Omnivorous
Pescetarian
Vegetarian
Vegan
Raw Vegan
Fruitarian
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What’s your reason for applying for the Healthy Dynamic Life Success System?* This field is required.
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What do you want to achieve?* This field is required.
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What is your current weight and dress size?* This field is required.
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What is your desired weight and dress size?* This field is required.
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What is keeping you from achieving your goals?* This field is required.
Accountability
Support
Motivation
Structure
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What do you think you could use the most help on?* This field is required.
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How committed are you to reaching your body-weight, health, and fitness goals?* This field is required.
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What would it be worth to you to reach your goal weight, size, and optimal health? $ amount * .
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Do you have the financial resources to invest in your growth?* This field is required.
I do not have access to financial resources and was looking for something cheap
I have access to credit to invest in my health
I have the funds available to invest into a high level coaching program, and I am the decision maker of my health. I acknowledge and know that investing in myself by paying someone who can help me shorten the learning curve and get results is worth more than the money that’s exchanged and will last a LIFETIME.
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If you’re accepted to work with Lexi, how soon can you get started?* This field is required.
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Please let us know why we should choose to work with you.* This field is required.
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Have you watched Lexi’s Masterclass “How a Food Addict Like Me Released 70 Pounds in Less Than 3 Months Without Restricting Calories, Controlling Portions or Cutting Carbs?" Watching this webinar is required before getting started (It’s to ensure your success)* This field is required.webinar link: https://bit.ly/lexiclass
Yes
No, but I’ll watch it right now (bit.ly/lexiclass)
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How likely are you to fully participate in the program?* This field is required.
I’m 10/10 going to show up. I’m the type of person who values others’ time and shows up to appointments so I don’t waste anyone’s time. (And if I can’t make it, I reschedule with ample notice).
I’m 8/10. I’m the type of person who usually shows up to appointments with others on time, or at least reschedules with ample notice.
I’m 6/10. I’m the type of person who is okay with flaking on others and then ghosting them, leaving them waiting for me without notice, or I might cancel last minute.
I’m 4/10 or below. I’m the type of person who just books appointments but has no intention of actually showing up.
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What achievement are you most proud of in your life?* This field is required.
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Please provide us with any additional information you think we should know.
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Agreement* This field is required.
Please use this form for a complete evaluation. Send no money with this application as there is no application fee. Once we receive this application, you will be contacted by an Admissions Adviser within one to two business days so as to answer any questions that you may have and to discuss the enrollment process. NOTE: If you have not heard from our office within 4 business days, you must call or email us to make sure we received your application. Upon approval of your application, you will be sent a contract to officially become a student of Healthy Dynamic Life Success System. NOTE: If for any reason you have questions about the form, please email lexi@healthydynamiclife.com. Thank You!
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And remember, you are not broken. This problem can be fixed with the right help no matter how long or hard you have struggled.
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