Pre-Call Questionnaire

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

What made you decide to book this call today?* This field is required.What’s been most frustrating about your body or fat loss lately?

4

Which best describes where you are right now?* This field is required.

Perimenopause (cycles changing, symptoms starting)

Menopause (no cycle / post-menopause)

Not sure, but things definitely feel different

I’m not in this stage yet, but I'm looking to make a change to my health habits

5

What have you already tried in order to lose weight?* This field is required.

Eating fewer calories

Cutting carbs

Intermittent fasting

More cardio / walking

Strength training

Tracking macros

Programs, challenges, or coaches

“Honestly… everything”

6

Which statement feels most true for you right now?* This field is required.

I’m doing a lot and getting little to no results

I get results briefly, then regain

I’m exhausted and don’t trust my body anymore

I feel stuck and don’t know what to change

I want a smarter plan that actually fits this stage of life

7

What would feeling successful look like for you 3–6 months from now?* This field is required.(This doesn’t have to be just about weight)

0/0

8

If we decide this is a good fit, are you open to coaching support (not just information) to reach your goals?* This field is required.

Yes, I’m open to support if it makes sense

Maybe — I need to understand how it works

No — I’m just looking for information

9

Anything else you want me to know?(Optional)

10

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