We Have Moved Away From "Weight-Loss"! Watch To Learn How We Reverse Metabolic Dysfunction And Why It's Changing the Industry!
Full Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
Why did you stop the first time? Or the third time? What made you choose to quit? I need to know this info so we can help you more effectively this time!
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Why now? What do you think will be different in your life when you get to your healthy lifestyle goal(s)?
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If you could NOT fail...What would your dream health/weight goals look like?
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Any medicines? Thyroid, Anxiety, Depression or Off Label Diabetes Injections?
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Are you currently on a medical weight loss shot? example: Ozempic
Are you interested in GLP1 support, muscle/hair support, weight-GAIN, Increased energy, get off meds, Body Fat-LOSS or ...?
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Are you being treated for any of the following?
Gout
Type 1 Diabetes
Type 2 Diabetes
Thyroid Disease
High Blood Pressure
High Cholesterol
Heart Complications
Other
none of the above
Are you.....
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Pregnant
Nursing
Pre Menopause
Post Menopause
none of the above
How many meals do you currently eat per day?
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Rate your quality of sleep.
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Scale 1-10 (1= Horrible / 10 = Excellent)
Do you exercise?
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How far away are you from your goal?
How many other programs have you tried? Lord...knows I tried at least 30 in my lifetime!
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On a scale of 1-10, how committed are you to getting to your health goals?
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Your age?
BTW, we are going to change it so your aging BACKWARDS!
What is your last know body fat percentage?
If you do not know, leave blank, I will help you with this
What is your last known skeletal muscle percentage?
If you do not know, leave blank, I will help you with this
Who was your original Optavia Coach if it wasn't me? What could they have done better or differently to help you on program? (Please be open & honest)
I am 100% confident in the program and its ability to work for everyone. Literally, you are the only variable to the programs success. It's simple, not always easy, but the things that matter in life are never easy. I know you can lose the weight you want with my help, but with you being the only variable, you have the control. How does that make you feel? Scared? Good! I was too. BUT, my life was in shambles because of all the things I could NOT control. I decided to be excited that I could control one part of my life. How do you feel now? I am so excited to work with you!
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