You Are The Prize!
Road to your goals starts here
Name
*
First Name
Last Name
What’s your Email Address
*
What’s your phone number?
*
How active are you?
*
Workout 5-6x a week
Workout 3-4x a week
Workout 1-2 a week or intense work
Not very active
What is your current age, weight & height?
Estimate your weight if unknown.
What is your biggest fitness Struggle?
*
How long has this been a struggle for you?
*
What’s your #1 fitness goal?
*
How many times do you eat a day?
*
1 meal a day
1-2x a day
2-3 a day
4 or more a day
How much do you spend on fast food/coffee a day?
*
$0-5
$6-12
$12-20
$25+
Have you tried Herbalife before?
No, not interested
No, not yet!
Yes, it’s been a while
Yes, I currently use it
Which of these are important to you?
*
Weight loss
Muscle gain
Reduce blood pressure
Energy & endurance
Healthier digestive system
Healthier skin, Rid of sugar cravings
Positive self esteem
Health education
What is your monthly budget that you can invest into your health/goals?
$50-$140 just getting started
$150-$220 need a push
$230-$300 New levels
$350+ disrespectful results!
Are you looking for in person training?
*
Personal training
Group fitness
guidance & nutrition
Nutrition only
Do you live in Los Angeles/Orange County?
Yes
No
Best time to reach you?
*
Mornings 7am-11am
Early Noon 12pm-3pm
Afternoon 3pm-6pm
Evenings 6pm-10pm
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