Learn Wellness Readiness Form
Share your experience and help us improve.
Full Name
First Name
Last Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What's your 'this is why Im ready to lose weight' statement?
What's the goal you have in mind for yourself? How you'll look? How you'll feel and what it'll mean to you?
Are there any other reasons why you struggle to lose weight?
How many times have you tried to lose weight?
Describe what you usually do when attempting to lose weight?
If weight loss were broken down into daily can do tasks, would you feel better about it?
Do you have what you need to get started or are you missing one of these? Facility, support, a plan, accountability?
Does your workplace support workplace wellness?
How would you feel physically if you lost 10% of your body weight?
Which statement is most true? I have a healthy lifestyle or I eat a healthy diet?
Rank these from most true to least true. I need to adopt a solid plan. I need to eat better. I need to move more.
When you experience a setback or plateau, what do you do?
How did you find us? (where was the link to our site posted at?)
Last question, if I helped you map out your next 15 days in order to lose 7 pounds, would that be helpful?
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