You can always press Enter⏎ to continue
🌈 Stubborn Belly Fat, Low Energy, Anxiety? Find out the #1 reason WHY?
This questionnaire will take you less than 2 minutes to find out the #1 hidden thing keeping you from feeling confident, fit & sexy — and how to finally fix it.
12
Questions
START
1
Full Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
What is your IG handle?
*
This field is required.
Previous
Next
Submit
Press
Enter
3
How do you feel when you look in the mirror 🪞right now?
*
This field is required.
Confident & proud
Neutral but could be better
Avoid looking too closely
Critical & frustrated
Previous
Next
Submit
Press
Enter
4
When was the last time you felt consistent with your fitness or nutrition routine?
*
This field is required.
Right now — I’m in a groove
A few months ago
A year or more ago
Never felt truly consistent
Previous
Next
Submit
Press
Enter
5
What usually derails your progress ?
*
This field is required.
Work stress, burnout & lack of time
Social life / Events / Overeating
Gym anxiety
Lack of accountability / support
All of the above
Previous
Next
Submit
Press
Enter
6
How is your energy ⚡️ throughout the day?
*
This field is required.
High & steady
Okay but dips in the afternoon
Low — I drag myself through the day
Completely exhausted most days
Previous
Next
Submit
Press
Enter
7
When you’re stressed, what happens first?
*
This field is required.
I skip workouts (for weeks or months)
I overeat or binge
I lose motivation (more anxious and depressive thoughts)
All of the above
Previous
Next
Submit
Press
Enter
8
What’s your relationship with food 🍝🍱🍕?
*
This field is required.
I track macros obsessively
I eat clean but sometimes binge
I eat intuitively & feel good about it
I don’t think about it much
Previous
Next
Submit
Press
Enter
9
What’s your biggest goal 🏆right now?
*
This field is required.
Lose fat / look leaner
Build muscle / look stronger
Have more energy & better health markers
Feel confident & sexy again
Previous
Next
Submit
Press
Enter
10
How much weight are you looking to lose?
5-10 lbs
10-20 lbs
20-30 lbs
30+ lbs
Previous
Next
Submit
Press
Enter
11
What exactly do you mean by "build muscle and get stronger"?
Bulk and look more Defined
Leaner and more Toned
Six Pack abs
Overall just Stronger and more Energized
Previous
Next
Submit
Press
Enter
12
What does having more energy & better health markers mean to you?
Consistent energy throughout the day ↗️
Improve libido 😈
Less reliant on coffee ☕️
All of the above
Previous
Next
Submit
Press
Enter
13
What does "feeling sexy and confident" mean to you?
Feeling sexy looking in the mirror 🪞
Feeling more confident & powerful in my career 🌟
Feeling hot in my favorite pair of underwear 😈
All of the above
Previous
Next
Submit
Press
Enter
14
How ready are you to commit to change?
*
This field is required.
100% — let’s go!
I’m ready but need guidance
Curious — I want to dip my toes in
Not ready yet, just exploring
Previous
Next
Submit
Press
Enter
15
Optional:
The more I know the more I can give you feedback on your health assessment. This here is for you to share anything on your health & fitness journey that might be important for me to know.
Some examples: Your past and current fitness journey. Your weight loss journey in recent years. Why you want to feel more sexy and confident. Your biggest desire why you want to get fitter…
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
16
What’s your best email for me to send you your personalized game plan to?
*
This field is required.
example@example.com
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
16
See All
Go Back
Submit