BODi Block Interest Form
I’m so glad you’re here! Fill out this form and I’ll get you the info you need to make a decision on whether these at-home workout programs are right for you!
Name
*
First Name
Last Name
Email
*
example@example.com
Instagram Name (if applicable)
Phone Number (if you don’t check email that often, highly recommend leaving this for me… don’t worry, I’ll only text unless we set up an appointment to speak on the phone)
Please enter a valid phone number.
Format: (000) 000-0000.
Are you a current BODi member?
*
Yep!
I was but no longer am
Not yet
I don’t know what BODi is
Is Jackie YOUR coach?
*
Yes!
No, I have a different coach (list below)
No coach yet
Name of your coach (if not Jackie)
What type of workouts are you most interested in trying? (check all that apply)
*
Cardio/HIIT/Running
Spin/Cycle
Weightlifting
Ballet Barre
Pilates or yoga
Shadow Boxing
Step
Dance
I’m not sure yet
What do you struggle with when it comes to your nutrition and dieting? (check all that apply)
*
Staying away from sugar
Eating too much
Nighttime snacking
Food aversions
Not eating enough
Never feeling full
Never feeling hungry
Binge eating
I eat really healthy already
What equipment do you currently own? (Check all that apply)
*
Spin bike
At least 2 sets of dumbbells
An aerobic step
Resistance loops
Yoga mat
Kettlebell
A pull-up bar
A weightlifting bench
No equipment yet
Share with me a little about your goals and what you have tried in the past that has or has not worked. (REQUIRED if we have never worked together before)
Would you be willing to invest in our entire system (workouts, nutrition, superfoods, and support) for just 30 days if I could offer you a money-back guarantee?
*
Absolutely
Maybe
Probably not
I really just need more motivation
I have previously purchased a Total Solution Pack
Where are you in your decision-making process? (NEW challengers only)
I’m ready - send me a link to purchase
I’d like to set up a phone call with my coach
I’d like to be sent an informational video
I’d like to talk pricing first
Are you interested in participating in our HealthBet so that you can stay motivated and inspired throughout your journey? This would require a buy-in of $10-$20 and would also require that you log your workouts and supplements on our BOD application each day.
*
YES! I need this!
I think I would!
Not for me
I'm not sure - can you tell me more?
I’m here for you…
I can’t wait to get in touch and get your questions answered - I’m sure you have a lot! Watch your email s and texts carefully so that you don’t miss anything from me. Until then, take care of YOU. 🫶🏼
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