Survey

1

Name

First Name

Last Name

2

Email

example@example.com

3

Phone Number

Please enter a valid phone number.

6

Are you currently incorporating health and wellness in your life?

YESNO

7

If there were three things you could improve about your health, what would they be?

8

Do you know how much protein you need daily to maintain your lean muscle mass?

YESNO

9

Do you know how many calories your body burns daily?

YESNO

10

Are you aware most people are protein deficient?

YESNO

11

Are you aware that a 35% body fat rating or greater is considered stroke ready?

YESNO

12

Do you know what your body fat % is?

YESNO

13

Would it be valuable to you to know all this information about yourself?

YESNO

14

Would you like a FREE Wellness Evaluation?

YESNO

15

Day and time best to contact you?Monday-Friday between 3pm-6pm, Saturday 2pm-6pm