1:1 IB

1
What is your name?* This field is required.
First Name
Last Name
2
What is your preferred email address? * This field is required.
example@example.com
3
What is your Instagram and Facebook handle/name?* This field is required.If you do not have one of these platforms simply write: n/a
Instagram
Facebook
4
What is your Instagram handle?
5
Phone Number* This field is required.This will be used to schedule our call, it is never used for marketing purposes
Please enter a valid phone number.
6
How old are you?Age is just a number but it will help make better recommendations for you based on your metabolism.
7
What is your job / scheduled like daily? * This field is required.So we can see activity levels and identify stress as well.
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8
What is your #1 struggle in your fitness / nutrition / wellness journeys right now. * This field is required.
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9
How long have you been struggling for + why is now the time to change? * This field is required.
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10
What will happen if you do not commit to actively investing in your fitness and health?* This field is required.
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11
What have you tried that has not worked so far?* This field is required.
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12
What is your current relationship with food and your current eating habits? Do you get regular hunger cues, eat 3-5 meals a day, history/current Eating Disorder or any allergies I should know about? Do you fall “off track” on the weekends?* This field is required.
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13
How confident are you in your ability to commit time, energy, and invest in your health to reach your goals?* This field is required.
I am ready and willing to invest both time and money into improving myself and making my health a priority. With this program that promises to deliver results
I am not sure if I can make the both time and monetary investment in my health.
14
SUMMARY
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