Welcome
Have a few minutes? Let us know how we can best help! www.FindYourShineWithin.com
Full Name
*
First Name
Last Name
1. What do you consider is your biggest health challenge right now? Choose all that apply.
*
Chronic Pain
Low Energy
Mood Swings
Anxiety
Losing Weight
Can't Focus, Scattered Attention
Sugar Addiction
Endless Cravings
Digestive Issues
Insomnia, Poor Sleep
Emotional Eating
Brain Fog
Sick Often
Other
2. What do you feel is the biggest obstacle holding you back from overcoming your pain points? Choose all that apply.
*
Time
Burned out, Overwhelmed
No support from friends or family
Hard to make changes in my current environment.
Too much conflicting information out there and don't know where to begin
Tried before and doesn't work for me
Don't know what to eat or cook
Know what to do, but hard to implement into daily routine
Other
3. What are your favorite ways to learn when it comes to your health? Choose all that apply.
*
Written text (PDFs, books, manuals, etc.)
Video
Audio
Group coaching
One on one coaching
Virtual webinars
Live in-person workshops or events
Facebook Groups
Other
4. What would you like to achieve? Choose all that apply.
*
Building your immune system
Quitting sugar
Planning healthier meals, recipes, shopping lists
Having a happy healthy gut
Improving mindset/mental wellness
Curbing emotional eating/end cravings
Making healthy habits stick
Losing weight and keeping it off
Eating healthy on a busy schedule
Making healthier meals the whole family will enjoy
Other
5. What is your biggest frustration or fear when it comes to your health? If you chose “other” in the answers above, you can also elaborate on those in this section.
*
Thanks for taking the time to share a bit of your health journey! In a nutshell, we help folks reach their health goals with a real-life focus and sustainable plan that fits YOU. Everyone's path is a little different. Would love to hear more about your goals, lifestyle, long term direction– so we can make this reset truly work for you.
6. Would you like to have a chat to hear how our clients are finding success?
*
Yes
No
Maybe
Phone Number
*
Email
example@example.com
Submit
Should be Empty: