Enjoy Swirls From Home

Swirls at Home – Let's Get Started!

Hey there 👋

We’re so excited you’re ready to start your Swirls journey from home 💙

Whether your goal is to boost energy, improve your nutrition, or feel amazing each day, this quick form will help us personalise a plan that fits you perfectly.

Once you’ve submitted it, one of our Swirls coaches will be in touch soon to help you get started!
🧍‍♀️ SECTION 1 – About You
1. Name

Street Address

Street Address Line 2

First + LastState / Province

Postal / Zip Code
2. Phone Number

Street Address

Street Address Line 2

💬 We’ll text you to confirm your details and next steps.State / Province

Postal / Zip Code
3. Suburb/Town

Street Address

Street Address Line 2

🏡 This helps us connect you with your nearest Nutrition Studios and wellness eventsState / Province

Postal / Zip Code
4. Email
example@example.com
5. Instagram Handle (optional)
📲 If you’d like us to connect with you there
🎯 SECTION 2 – Your Goals & Lifestyle
6. What are your main goals right now?
7. What’s your biggest struggle when it comes to nutrition or feeling your best?
💭 e.g. lack of time, low motivation, not sure what to eat, snacking, etc
8. Do you currently use any nutrition or wellness products at home?
**Please note, if you are already a Herbalife client or receiving coaching with someone else, please reach out to them for support with your goals**
9. How active are you during a typical week?
🥤 SECTION 3 – Your Swirls Experience
10. Have you tried Swirls drinks before?
11. Which products are you most interested in?
💬 SECTION 4 – Next Steps
12. How would you like us to help you get started?
13. Preferred way to contact you
Please choose one
14. How soon would you like to get started?
🔒 SECTION 5 – Final Step
15. Anything else you’d like to share?
Thanks for completing your Swirls at Home Form!

Your details are safe with us 💙 We’ll only use this info to help you reach your goals and feel amazing on your Swirls journey.We’re so excited to help you get started 🥤

One of our Swirls coaches will reach out soon to chat about your goals, recommend a personalised plan, and help you make your drinks at home with ease.
Should be Empty:

🧍‍♀️ SECTION 1 – About You

🎯 SECTION 2 – Your Goals & Lifestyle

🥤 SECTION 3 – Your Swirls Experience

💬 SECTION 4 – Next Steps

🔒 SECTION 5 – Final Step