Weight Loss Consultation

Weight Loss Consultation

Great job taking the first step to making a successful change in your health & wellness, with highly effective science proven weight loss that will allow you to lose weight, and keep it off long term.
This form will take you about 10-15 minutes to complete depending on your answers.

Please be as detailed as possible. The more information you provide, the better I will be able to help you with your goals. If you would prefer discuss your goals over a phone or video consultation instead (upto 60min), please click here. You are also welcome to fill out this form AND book a phone consultation too if you wish.
Your Details
First Name:
Last Name:
Email
example@example.com
Phone Number
Please ensure you double check
Commuication Preferences

Other

Your Weight Loss Journey So Far
What are your biggest struggles when it comes to losing weight?
E.g. motivation, sugar cravings, accountability, knowledge, etc
How long have you tried to lose weight?
Roughly, how long have you been overweight?
What have you been doing (if anything) to try and lose weight?
Think about what you've tried in the past, and whether it worked or not, and let me know of anything you are currently doing and how that's been going for you...
In the past month or two, how would you describe your weight?

Other
How is your weight loss environment, both at home and at work?
Do work collegues regularly bring in cakes, sweets, chocolates at work? Do you need to attend work events that require you to eat out or eat what is given? Have you got a partner and/or chidren with unhealthy options and bad habits been common place around the home? Do you walk past junk food stores (Greggs, McDonalds., etc) to and from work?

Your Details