WEDO WELLNESS
Thank you for trusting me with your wellness journey. To support you at the highest level, I need to understand you—your story, your goals, and where you’re starting from.I’ve been there. I once struggled with poor nutrition, eating once a day and weighing 160 lbs. Through training and proper nutrition, I gained over 20 lbs of lean muscle and dropped to 12% body fat.Now it’s your turn.Fill out this form and let’s get excited about the lifestyle change ahead. Once submitted, you’ll hear from me within 24–48 hours.Let’s work. 💪
Name
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First and Last Name
Best contact Email
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Best contact ph #
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Please enter a valid phone number.
Format: (000) 000-0000.
What is your social media handle IG or FB (@_____)?
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Weight | Height | Age
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190 | 5’11| 35
What's your ideal weight goal?
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Sex
Female
Male
My goal is to (check all that apply)
Lose weight
Lose belly fat
Increase my energy levels
Gaining muscle or enhance my curves
Info about getting paid for reaching my goals
Better digestive health
Gain muscle
How soon are you looking to get started?
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As soon as possible
I was READY yesterday!
Not sure yet I need more info
Based on your goal and the results you want to achieve, what's your current monthly wellness budget.
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$150-$250
$250-$400
$400-$600
$600+
Do you currently or have you in the past, used Herbalife Nutrition Products?
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Best time to contact you?
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Please give a couple time slots
Briefly provide further details regarding your current health goals and what areas of focus you would like to work on together. Be as specific as possible.*
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Based on your goal, how many days a week can you commit to working out?*
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1-2 x per week
3x per week
4+ x per week
I don’t want to workout.
Do you have any dietary preferences or restrictions ?
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Very important to create custom plan
What challenges have kept you from getting results in the past? (Check what applies)
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I start strong, but I lose momentum I feel tired or drained most days
I don't have support or guidance
I didnt see results fast enough and gave up
Life got in the way, too many other priorities
After helping thousands of people transfrom their lives, there's one thing I've learned--that you are unique. Your journey is like no one else's, so let's create a plan just for you.- Coach Ray
Who do you know that would do this program with you ? State as many as you’d like
Referral program
Submit
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