Full Name
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First Name
Last Name
E-mail
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Phone Number
*
-
Area Code
Phone Number
Who told you about this program?
*
(Select all that apply)
This is my FIRST TIME doing a program.
I have done a program with you before, but it has been over 3 months.
I have done a program with you within the last 90 days.
I am a returning VIP Member/Coach.
I am interested in: (Select all that apply)
14 Day Detox & Declutter m (A nutrition, fitness, mindset reset)
The 4th Quarter Thrive & Lock In Transformation & Accountability Program
5 Day Morning Routine Program
Thrive Drum Cardio Training ™
I’m not sure yet, but I do know that I am ready to transform
We Want to know more about YOU.
(If you are already working with a coach & joining to continue your program, it is not required to complete the questions below.)
HOW DO YOU FEEL NOW VS HOW YOU WANT TO FEEL AT THE END OF THIS PROGRAM? (PHYSICALLY, NUTRITIONALLY AND/OR MENTALLY)
Check all that apply in regards your goals:
I want to lose weight 5+ pounds
I want to focus on burning fat
I want to boost my energy
I want more accountability to stay motivated
I want to flush out my system
I want to feel more confident in my body
I want to create a better self-care routine
What is stopping you from reaching your goals?
Not making the time
Prioritizing everyone but ME
Lacking accountability
Not feeling motivated/tired
Emotional eating
Needing a clear plan
On a Scale of 1-10, how important are these goals to you?
On a Scale of 1-10, how willing are you to commit to being consistent, checking in with your coach, and being held accountable?
Are you... vegan or vegetarian
Please Select
vegan
vegetarian
neither
How many times a day do you eat?
1-2
3-4
5-6
not much at all
How much money do you spend on food a day?
$30+
$20-$30
$10-$20
$5-$10
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