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Hi, please fill out and submit this questionnaire to get your personalised hacks for how to hit your goal.
12
Questions
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1
Name
First Name
Last Name
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2
What's your Instagram handle?
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3
What's your main goal right now?
Pick as many as you like
Fat Loss
Better relationship with food
Maintain where I am
Feel free to enjoy the holidays without guilt
Not feeling too busy to focus on me
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4
Are you currently working towards your goal?
No, I don't know where to start
Yes, for 1-6 months
Yes, for 6-12 months
Yes, it feels like I've been working on it forever
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5
Do you currently exercise
At home, the gym, classes or cardio
No
1-3 times a week
4-6 times a week
7+ times a week
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6
Are you currently tracking your food and calories?
YES
NO
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7
If yes, what's your calorie target?
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8
What is your average daily step count?
Up to 4,000
4,000 - 8,000
8000-10,000
10,000 +
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9
Are you ready to make your goal a reality?
YES
NO
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10
If there's one thing that would make you feel happier over the next month that I could give you advice on (gym, nutrition, movement, mindfulness with eating etc) what would it be?
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Ok
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11
How good would it feel to hit your goal right now?
1
2
3
4
5
I don't care
It would be amazing
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12
Thanks for completing the form! Nourish & Thrive by Amy Louise will be in touch with you via Instagram DM's to give you your feedback and advice on how to best move forward!
If you have anything else to add, please do here
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13
Nourish and Thrive coaching offers you a fast pass to your goals and helps you make them a reality. Would you like to know more info on how I can do this with you?
I'm excited and want to sign up!
Yes, I'd like to know more
Not right now thanks
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