WELLNESS PROFILE

START YOUR TRANSFORMATION NOW!!

*** Read Carefully ***
How does it work?

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

2. Once completed send me a message - to let me know that you have finished filling out the questionnaire.

3. Wait for me to get back to you - I'll review your responses and get back to you with either a voice message or text. This is usually within 24-48 hrs depending on when you completed the questionnaire.

4. You decide - you decide if you want to become a client of mine and move forward with your recommended plan of action.
EVERY MONTH I HELP NEW PEOPLE ACHIEVE THIER GOALS:
- Fat loss
- Gain muscle mass
- Body recomposition
- Better digestion
- Better skin
- More energy
- Better sleep
- Better nutrition habits (no starvation)
- Improved mindset (most important)
MY PROGRAM IS BASED ON A SIMPLE CONCEPT:

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

I'll help you accomplish everything according to YOUR goals & YOUR lifestyle. I adapt to you and your schedule and the WE WORK TOGETHER to guarantee your results.
HOW TO BECOME MY CLIENT:

When you decide you are ready to get started here's what happens next.

1. We will choose a supplement kit/plan specific to your needs and objectives that will help optimize and accelerate your results.

2. You will place your order with me or have the option to open a VIP account ($$$ discounts for you)

3. You'll get access to my client group filled with:
- Loads of recipes
- Workouts
- Tips & tricks
- Meal prepping information
- Mindset motivation
- Accountability
- Like minded individuals & more
Plus most importantly you'll have access to me daily to help guide you and answer any questions you have along the way!!

ALL OF THIS IS FREE WITH THE PURCHASE OF YOUR SUPPLEMENT KIT/PLAN!! No more paying for a workout program or meal plan.

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Be honest & Be truthful. There is no judgment here!!

This questionnaire will allow me to know you better and identify your needs. Don't be afraid to answer the questions.

No one else sees them but me.

❤️ - Coach Trish
Name

First NameLast Name
Email
example@example.com
Age
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Your Instagram username & Facebook Username:
I want to lose weight.I want to gain energy and have better nutrition.I want to gain muscle.I want better digestion/less bloating.I want to sleep betterI want healthier skin.Other
30 days60 days90 daysAs long as it takes
With nutritionWith workoutsWith my mindsetOther
What do your meals look like in a day? Describe to me a typical day of everything you eat or drink.
MotivationNot know what to eatNot having "time"No support systemI don't want to workoutOther
YesNo
YesNo
If you answered yes to the above question, please list your medications and for what health condition you take them for.
YesNo
If you answered yes, which ones and for what purpose?
OftenSometimesNeverI have IBSI have crohnsI have endometriosis/pcosOther
YesNo
YesNo
I don't do any sports or exerciseI don't workout, but I am active (example daily walks)I train 1-3x a weekI train more than 3 times a week
HomeGymGroup fitness classesOther
I have insomniaI wake up frequentlyGreatHit or miss with good night's and bad nights
YesNoSometimes
>100mg100-200mg200-300mg400mg or more
Do you tend to snack? If yes, what time of day?
Are all food groups part of your diet? If not, for what reasons?
Do you have any food allergies? If so, please list them below.
Do you have any diagnosed or undiagnosed eating disorders?
123More than 3
Do you include snacks in your diet? If so, can you give me examples?
Do you eat out at a restaurant or fast food? If yes, how many times per week and what places?
How much on average do you spend on fast food or eating out?
Do you grab convenient foods like from gas stations, etc? If so, what kind of things do you get?
Do you have a part of your body where fat accumulation is greater?
AcneEczemaCelluliteStretch marksFine line & wrinklesNone
Have you ever tried herbalife products before? If yes, what products have you tried?
Who was your Herbalife Distributor or Coach?
$100-$150$150-$200$200-$250$250-$300$300 and above
If you know someone interested can you drop their contact information below?
Is there any other relevant information that you want to share that would be helpful to me?
Did anyone refer you to me? I would like to thank them with a gift. Our buisness is built on referrals. If you have anyone interested in health goals, send them this form. THANK YOU!!
Thank you for your responses! I appreciate you being open and honest in your answers.

This is the 1st step to achieving your goals.
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START YOUR TRANSFORMATION NOW!!