1 PERSONAL INFORMATION
  • This short questionnaire will allow me to know more about you, your habits and your goals.
    Have a clearer vision of the areas of progress that we will work on together, for you
    allow you to achieve your objectives in the best conditions. So, it is with kindness and good
    mood that I could offer you personalized support. I invite you to bring a
    maximum number of precise answers.

  • 1 PERSONAL INFORMATION

  • Format: (000) 000-0000.
  • exemple : 50 kg / if you do not know put an estimation

  • Create your own automated PDFs with Jotform PDF Editor- It’s free

  • Indiquez "NON" si pas de compte.

  • 2 YOUR GOAL

  • My goal is to check what concerns you
  • Reply if you just want to lose weight

  • Reply if you just want to gain weight

  • 3 YOUR NUTRITION

  • Create your own automated PDFs with Jotform PDF Editor- It’s free

  • Your daily amount of water
  • What else ?
  • 4 ACTIVE LIFE

  • How often do you exercise?
  • Create your own automated PDFs with Jotform PDF Editor- It’s free

  • You are interested in a
  • 5 OTHER INFORMATION

  • exemple : yes, i am pregnant

  • Have you ever consumed Herbalife before?
  • If yes, how long ago?
  • Are you interested in knowing how to earn extra income with Herbalife
  • I'm excited to help you achieve your goals and would love to help those you love do the same. I'm extending the offer of a FREE wellness assessment to 5 of your friends.

  • Create your own automated PDFs with Jotform PDF Editor- It’s free

  •  
  • Should be Empty: