Escape Plan Application

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Are you currently on a program or working with a coach?* This field is required.
YESNO
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Please describe your exact mind, health, and body goals.* This field is required.
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Why do you want coaching help with these goals?
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Why is this important for you to accomplish? * This field is required.
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Rate your satisfaction level with your body/fitness right now.* This field is required.Match the emoji face to your situation...
Row 0, Column 0Row 0, Column 1Row 0, Column 2Row 0, Column 3Row 0, Column 4
Row 0, Column 0Row 0, Column 1Row 0, Column 2Row 0, Column 3Row 0, Column 4
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What is your desire from 1-10 to reaching your goals?* This field is required.
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Never, I'm going to think about it forever.
So ready to go right now, no matter what it takes.
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What have you tried in the past to reach your goals?
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What do you feel is your #1 challenge or obstacle in reaching your goals?* This field is required.Think of anything that may hold you back, is currently holding you back, or has held you back in the past.
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If you had daily guidance through a personalized nutrition & exercise program along with accountability coaching, do you feel like you can succeed?* This field is required.
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We only work with people that are as serious about their goals as we are. Why should we fill a limited, high-demand spot to work with you?* This field is required.
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These are the typical reasons people avoid hiring a coach and either never reach their goals or take 10 times longer. Which one do you think holds you back most?* This field is required.
I look for the cheapest solution possible or never want to spend what it actually costs to get the results I want.
I never have time or too busy to start a program
l'm not the one making the financial decision
I always need to think about it even if it looks perfect for me
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What does winning look like to you? If you were to have a discussion with Nelson & Kelsi in 12 months from today and you were looking back over the past year, what would have had to happened for you to feel happy with your results and feel successful?* This field is required.Add as many details as you would like.
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Are you ready to make a decision and take action today if you are a good fit and invited in the program?* This field is required.We have some amazing fast-action bonuses as rewards to help motivate you to do it today!
YES!Still need to think it over.
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Are you willing to give your amazing transformation success story in a testimonial video with before & after pictures when you finish?* This field is required.You can remain anonymous.
YESNO
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Name* This field is required.
First Name
Last Name
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Best Email* This field is required.
example@example.com
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Phone Number* This field is required.
Area Code
Phone Number
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Please share any additional comments or concerns.Anything that may hold you back...
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