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  • Your FREE Wellness Evaluation

    Your FREE Wellness Evaluation

  • Based on the information given below, I will provide a detailed meal plan to help you achieve your health or fitness goals. This wellness evaluation will act as a roadmap taking you from where you are today to where you want to go. As a Health Coach, I know that in order to reach your goals, it takes 20% fitness, 80% nutrition and 100% mindset. If you're ready, let's begin! Fields marked with a (*) must be filled in please

  • Date of Birth*
     - -
  • When is a good time to contact you?
  • Gender*
  • How are your energy levels during the day?*
  • Are you often bloated or have difficulty going to the toilet?*
  • Do you often feel tired during the day?*
  • What is your breakfast routine like? (tick all that apply)*
  • Do you eat a variety of colourful fruits and veg?*
  • Do you drink at least eight glasses of water per day?*

  • How often are you eating the following:

  • Sweets*
  • Take aways*
  • Fizzy drinks*
  • Alcohol*
  • How often do you EAT OUT a week (this includes take aways)*
  • What are your health goals currently? (tick all that apply)*
  • Do you suffer from any of the following health issues? (tick all that apply)*
  • Please list 3 friends or family who you think would benefit from doing this FREE WELLNESS EVALUATION Please list Name and whatsapp number. Eg:  Pamela McLean, 076 485 1251
  •  NOW THAT THE HARD WORK IS DONE CLICK THE LINK BELOW TO SUBMIT
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