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What's your name?
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First Name
Last Name
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2
What's the best email to contact you?
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example@example.com
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3
What's the best phone number to reach you?
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Use country code 1 for US and Canada
Country Code
Area Code
Phone Number
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4
What is your age?
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5
What is your occupation?
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6
If you have kids, how many kids do you have?
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7
Are you interested in working with a specific Scooby Health coach?
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Please Select
Not sure, please choose for me
Jason Theobald
Alyssa Cooke
Curt Cook
E Ramey
Jamie Askey
Larry Wilson
Mason Prevost
Meghan Morrison
Sierra Ashe
Vicky DiSanto
Please Select
Please Select
Not sure, please choose for me
Jason Theobald
Alyssa Cooke
Curt Cook
E Ramey
Jamie Askey
Larry Wilson
Mason Prevost
Meghan Morrison
Sierra Ashe
Vicky DiSanto
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8
Please indicate if you are following any Scooby Health coaches listed below on Instagram:
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Jason - @jasontheobald_scoobyhealth
Alyssa - @alyssamcooke_scoobyhealth
Curt - @curts.fitness_scoobyhealth
E - @eramey_scoobyhealth
Jamie - @fit.nurse.etx_scoobyhealth
Larry - @liftingwith.larry_scoobyhealth
Mason - @mason_scoobyhealth
Meghan - @dr.meg_scoobyhealth
Sierra - sierrashe_scoobyhealth
Vicky - @vickydfitness_scoobyhealth
Scooby Health - @scooby_health
I am not currently following any Scooby Health coaches on Instagram
I am not on Instagram
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9
Please indicate if you are following any Scooby Health coaches listed below on Instagram:
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Jason - @jasontheobald_scoobyhealth
Alyssa - @alyssamcooke_scoobyhealth
Chandra - @coachc_scoobyhealth
Crystal - @coachcrystal_scoobyhealth
E - @eramey_scoobyhealth
Jamie - @fit.nurse.etx_scoobyhealth
Jane - @trainlikejane_scoobyhealth
Larry - @liftingwith.larry_scoobyhealth
Meghan - @dr.meg_scoobyhealth
Natasha - @natasha_scoobyhealth
Scooby Health - @ scooby_health
I am not currently following any Scooby Health coaches on Instagram
I am not on Instagram
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10
What's your current activity level?
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None. I spend most of my day sitting (less than 5000 steps per day)
I am active 3-5 days a week and spend a large part of my day on my feet (less than 10,000 steps per day)
I am very active 6-7 days a week and have a physically demanding job (greater than 10,000 steps per day)
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11
What is your weight training experience?
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I have no experience weight training
I have been weight training less than 2 years
I have been weight training greater than 2 years
I have been weight training greater than 5 years
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12
How often do you currently weight train?
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I do not weight train
I weight train 1-2 times per week
I weight train 3-5 times per week
I weight train 6-7 times per week
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13
What are your current diet/nutrition habits?
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Very poor! Help!
Some good days, some bad days - very inconsistent
I eat "healthy" but lack the knowledge or motivation to reach my goals
Great! I track macros and follow a consistent meal plan
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14
Which category of coaching are you interested in?
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You can choose multiple categories, if needed
General Nutrition
Functional Nutrition
Competition Prep
Competition Off Season
Weight loss resistance
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15
On a scale of 1-5, how ready are you to make a financial investment in your health?
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Choose 1, 2, 3, 4, 5
1 - still thinking..., 5 - beyond ready
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16
Why are you interested in hiring a coach?
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17
How did you hear about us?
ex: referred by friend, Instagram, FaceBook, our website, etc
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18
If you have an Instagram handle, please add it here:
This is NOT a required question
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