Take the QUIZ to see where YOUR metabolism is, right now, and let’s learn how restore your relationship with food for better health

1

NOTE: Please answer honestly, not how you think you ‘should’ answer, but choose the answer that describes you most of the time! Honesty is the best policy! And only choose ONE answer please!

2

Full Name* This field is required.Let Us Know Who You are below

First Name

Last Name

3

Email* This field is required.I will never sell or share your email with anyone I will need your email to send your results and recommendations. Privacy Is so important and its a must . Drop your email below

example@example.com

4

Sex and hormones impact how our bodies metabolize food. Which sex best describes you?* This field is required.Its all about our chemical balances and their relationship with food

Male

Female

5

People may identify themselves with more than just sex and hormones. What gender do you identify with?* This field is required.We are more chemical than we all think and our chemical make up plays so much bigger role .

Man

Woman

No Binary

Self Identify

Prefer Not To say

6

Age* This field is required.Drop Your age below

years

7

Weight* This field is required.Lets check your current weight

KG

8

Whats the activity level at your job?* This field is required.

None (seated all day)

Moderate (light activity such as walking)

High (heavy labor, very active)

9

How many Pounds / Kgs would you like to lose/gain, or what is your health goal?* This field is required.For your Goal make it short and to the point

10

What have you tried before and why did it not work for you?Drop a line or two

12

If so, which meals do you skip?This is not for people that do fasting

Breakfast

Lunch

Dinner

Snacks

13

Do you generally snack?

Yes

No

14

How many days a week do you eat out?

1-3

3-5

over 5

never

15

How much water do you drink daily?

1 glass

2-3 glasses

full gallon always

what's water?

16

What else do you currently drink?

Tea

Juice

Soda

Coffee/Energy Drinks

17

When are you the most tired?

Right when I wake up

Mid-day

After work

Other

18

What do you need the most help with?

Accountability

Just starting!

I've hit a plateau & I need to change that

Other

19

I have been on diets / cutting calories* This field is required.

A. For many years now, off and on

B. Rarely. I just eat according to my needs (even if I am slightly overweight).

20

As I age, my ability to lose weight is* This field is required.

A. Much harder. Sometimes it feels impossible! My body doesn’t respond the way it did when I was younger.

B. About the same. Not much has changed. If I put my mind to it, I can lose weight as usual

21

To lose the weight, I prefer to* This field is required.

A. Follow a ready-made weight loss or diet plan, with calorie counts and meal frequency. It makes it easier for me to stay on track when someone pens it out for me.

B. Manage my overall food intake. I kinda know where I slip up and I can get back on track fairly quickly, once I take a look at my portions, then I adjust accordingly.

22

My body’s ‘set point’ (what you usually weigh) has* This field is required. choose 1 option only

A. Increased over time. I can’t get back to my ‘ideal weight’, where it used to be when I was younger.

B. Remained about the same over time. I’m still at the same weight I was at years ago

23

When I put on a pair of pants, I notice : * This field is required. choose 1 option only

A. My waist band seems tighter and my pant legs are looser.

B. No real difference. My clothes fit the same as they always have.

24

How Hungry are you between meals , It:* This field is required.

A. Out of control! It never used to feel this intense! I get the ‘hangry pretty quickly

B. Manageable. I feel hunger but it’s not intolerable.

25

When the weekend comes around, I* This field is required.

A. Tend to go off the rails. I just want to enjoy my weekends off!

B. Pretty well stay the course. My eating doesn’t change that much

26

My diet consists of whole foods* This field is required.

A. Not often. I am busy, and ready-made meals or buying out is just easier for me

B. Most of the time. I will even prepare and take my food with me to work. I prefer it

27

I prepare and eat my own food: * This field is required.

A. Seldom. I am a busy person !

B. Most of the time. I love to cook at home. If I go out, I often take my food with me!

28

I like to do cleanses or detoxes to help me lose weight (or have done in the past* This field is required.

A. Yes

B. No

29

When I want to lose weight, I:* This field is required.

A. Do cardio

B. Adjust my eating

30

When it comes to training with weights, I* This field is required.

A. Do little weight training (less than 1 hour a week). I prefer other forms of exercise.

B. Make weight training my main event, 3-5 times a week.

32

Why?* This field is required.Drop a short explanation about your readiness rating

33

Are you willing to financially commit to changing your life?* This field is required.

Yes

No

34

How do you prefer to be contacted?We Value Your Privacy

Call

Text

Email

Other

35

Phone NumberIf you Prefer Text or call Please drop your contact number below

Area Code

Phone Number

36

Privacy Policy: If you would like to receive occasional updates/emails from me, please click the yes button below. We respect your privacy and don't share, divulge or sell your email address. You can unsubscribe from mailing at any time?* This field is required.

Yes. I'd like to stay connected

No, not at this time

I am already subscribed.

37

I am so excited that you decided to reach out to me to help you with your wellness goals! I can't wait to work with you! I'll reach out ASAP!