AJ Style of Fitness
Name
*
First Name
Last Name
Where are you located now?
*
Street Address
Street Address Line 2
City
Country
Postal / Zip Code
Contact Number
*
Format: (000) 000-0000.
How old are you now?
*
What are your current health goals?
*
Lower body fat percentage
Gain lean muscle or enhance my curves
Increase energy level
Improve general health
Enhance athletic performance
All of the above
Briefly provide further details regarding your current health goals and what areas of focus you would like to work on together:
Do you feel you receive balanced nutrition from the foods that you eat?
*
No
Yes
Which of the below do you regularly skip?
*
Breakfast
Lunch
Dinner
Snacks
Water intake
Other
Do you have any food allergies or dietary restrictions?
*
Are you currently using or have you in the past used Herbalife Nutrition Products?
*
Do you have a Herbalife membership?
*
On a scale of 1-10 (1=Not at all) + (10=I want it yesterday) how motivated or serious are you about reaching your goals as this time?
*
WORST
1
2
3
4
5
6
7
8
9
BEST
10
1 is WORST, 10 is BEST
How much are you willing to spend for improving your health/body shape?
*
HK$100 (US$13) per day
HK$150 (US$20) per day
HK$200 (US$25) per day
Alright, ready to get into the best shape of your life? Let's get started by submitting this form. Look forward to chatting with you soon.
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