Wellness Evaluation

HOW DOES IT WORK?

1- Complete this questionnaire on your lifestyle habits so that I can understand your needs and objectives

2- Once the questionnaire is completed, send me a message to me to let me know that you are done

3- I will get back to you shortly with my recommendations in voice messages when possible, or in writing

4- You can then decide if you want to become a client of mine

EVERY MONTH, I HELP NEW PEOPLE ACHIEVE THEIR GOALS:

- fat loss
- gain muscle mass
- body recomposition
- better digestion
- better energy
- better sleep
- best mindset (the most important!)

MY PROGRAM IS BASED ON A SIMPLE CONCEPT:

80% food + 20% training (optional) + 100% mindset!

I help you accomplish everything according to YOUR goals and YOUR lifestyle.
I adapt to you, and then we work TOGETHER to guarantee your results.

HOW TO BECOME MY CLIENT?
When you decide to become my client, this is what will happen:

1- We will choose a kit of supplements adapted to your needs and objectives that will help optimize and accelerate your results

2- Place your order with me or open a VIP account for you ($$$ discount)

3- I will give you access to my CLIENT FB group which contains:
- hundreds of recipes
- food plans
- an anti-bloating plan
- gym and home workout programs
- inspiring testimonials and stories
- an incredible supportive community
- access to coaches who respond quickly to the group

4- You also will have access to:
- a supportive VIP Group- personalized follow-up with me
- My availability to answer your questions on a daily basis

ALL THIS IS FREE WITH THE PURCHASE OF YOUR SUPPLEMENTS!
No more paying for a workout program or a meal plan!

This questionnaire will allow me to know you better and identify your needs.
Be honest and don't be afraid to answer the questions.
Your answers will remain between you and me.

With Love, Peyton <3

Name

Email

Age

Phone Number

Your Instagram and/or Facebook Name

CHECK ALL THAT APPLY

How much time are you willing to give yourself to achieve your results?

How would you like me to help you?

What do your meals look like in a day? Describe to me a typical day of everything that you eat and drink.

What are your biggest difficulties in achieving your goals?

Do you have a physically demanding job?

Are you currently taking any medication?

If you answered YES, what are the medications and for what health conditions do you take them for?

Do you take any supplements or vitamins?

If you answered YES, which ones?

Do you suffer from allergies, illnesses and/or intolerances? If YES, which ones?

Are you often bloated (feeling like your stomach is regularly swollen)?

Do you have a bowel movement every day?

Currently, where are you with physical activity?

If you train, where do you do it?

How is your sleep?

Do you suffer from anxiety, stress?

How much coffee/tea/stimulant do you drink per day?

Do you tend to snack? if YES, at what time of day?

Are all food groups part of your diet? if not, for what reason?

Do you have any diagnosed or undiagnosed eating disorders?

How many meals do you eat per day?

Do you include snacks in your diet? If so, do you have any examples?

Do you eat at a restaurant? If yes, how many times per week and what kind of restaurants?

Do you have a region of your body where fat accumulation is greater?

Do you have any skin problems that bother you?

Have you ever tried any Herbalife prodcuts? If yes, who is your coach?

What is your budget?

Is becoming a Herbalife distributor to generate additional income something that might interest you?

If you have someone interested, can you drop their contact info.

Any additional information that would be relevant to share with me (:

Did anyone refer you to me, I would like to thank them with a gift! Our business is built on referrals, if you have anyone interested in health goals send them this form! Thank you!

START YOUR TRANSFORMATION NOW!