Vital Health Expo Programs

Date

Name

First NameLast Name

Phone Number

Format: (000) 000-0000.

Email

example@example.com

Birth Date:

Date

Current Weight

Goal Weight

My main goals are focused around

What do you eat and drink on a regular basis?

Do you have any food allergies or intolerances? If yes, list below.

Do you take any supplements or vitamins? If yes, list below.

Do you have any barriers to healthy eating, or changing your eating behavior? If yes, explain below.

Who referred you to this program?

Who is your Coach?

What is your FB page name?

Signature

My Products

Holistic Natural Cleanse

- 5 Days of Natural Cleansing of the Mind & Body - Mental cleanse of inner self sabotage - Mindshift to include Affirmations - Natural Holistic Body Cleanse - Clear Mindset and lose up to 12 lbs

$50.00 Quantity

Vital Health Bronze Package (30 day Program)

Here is what is included in The Vital Health Bronze Package: *Zoom Welcome Goal Setting Orientation* Zoom (2X) Check in Call with Group & Coach* 3 week Meal Plan * 3 week Grocery list* 3 Week Workout Program* Holistic Natural Cleanse* Mental Fitness - Mindshift Wellness* FB Accountability Exclusive Group * Build your own eating plan.

$75.00 How many months would you like to sign up for?

Vital Health Silver Package (30 day Program)

Here is what is included in The Vital Health Silver Package:* Zoom Welcome Goal Setting Orientation* Mental Fitness - Mindshift Wellness *2 week Meal Plan * 2 week Grocery list* 2 Week Workout Program* Holistic Natural Cleanse* FB Accountability Exclusive Group* Messenger Group Weight/Measurement Check In

$197.00 How many months would you like to sign up for?

Vital Health Gold Package (30 day Program)

Here is what is included in The Vital Health Gold Package: *Zoom Welcome Goal Setting Orientation* Zoom (2X) Check in Call with Group & Coach* 3 week Meal Plan * 3 week Grocery list* 3 Week Workout Program* Holistic Natural Cleanse* Mental Fitness - Mindshift Wellness* FB Accountability Exclusive Group* 1 on 1 Coach Call (2X)* Workout Plan* Messenger Group Weight/Measurement Check In

$297.00 How many months of coaching do you want?

The MVP - Exclusive Coaching w/ Coach Lida

Here is what is included in The MVP Program:* Zoom Welcome Goal Setting Orientation* Mental Fitness - Mindshift Wellness* Zoom (4X) Check in Call with Group & Coach* 3 week Meal Plan * 3 week Grocery list* 3 Week Workout Program* Holistic Natural Cleanse* FB Accountability Exclusive Group* 15 min - 1 on 1 Coach Call with Coach Lida (4X)* Messenger Group Weight/Measurement Check In* Exclusive Workout Regimen

$597.00 How Many Months of 1 on 1 Coaching

Enter coupon

Total

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Vital Health EXPO-Programs

My Products