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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
Ally Frerichs
Alyssa Cooke
Curt Cook
E Ramey
Jamie Askey
Jane Karlson
Kasaundra Jensen
Larry Wilson
Mason Prevost
Meghan Santa Barbara
Sierra Ashe
Vicky DiSanto
Please Select
Please Select
Not sure, please choose for me
Jason Theobald
Ally Frerichs
Alyssa Cooke
Curt Cook
E Ramey
Jamie Askey
Jane Karlson
Kasaundra Jensen
Larry Wilson
Mason Prevost
Meghan Santa Barbara
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
Ally - @coachedbyally_scoobyhealth
Alyssa - @alyssamcooke_scoobyhealth
Curt - @curts.fitness_scoobyhealth
E - @eramey_scoobyhealth
Jamie - @fit.nurse.etx_scoobyhealth
Jane - @trainlikejane_scoobyhealth
Kasaundra - @kasaundra.jensen_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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