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Last Name

Last Name

Email

Phone

Is this a mobile number? Is this a mobile number? YES NO

Facebook Profile url? (for our virtual support community)

City, State and Country

What are you looking for? What are you looking for? SHED POUNDS TONE UP JOINT SUPPORT

Are you a shake person or not? Are you a shake person or not? Yes No Not sure

What is your monthly budget to invest in our health? -- What is your monthly budget to invest in our health? --$100$100 - $200$200 - $300

What best describes your fitness level? -- What best describes your fitness level? --The couch is my best friendI only walk when I have toI try and go for walks once in a whileI work out at least once a weekI workout regularly (run, home, gym, or camp)I run marathons before breakfast

What would you say is your favorite type of workout? What would you say is your favorite type of workout? Cardio Muscle building Less than 30 mins Slim and Toning Dance Low Impact Yoga Choreographed

What do you struggle with most when it comes to fitness and working out?

What do you struggle with most when it comes to your nutrition?

Which is stronger? -- Which is stronger? --Your FitnessYour Nutrition

What does your typical day look like with food? (no judgements)

How often do you eat out? -- How often do you eat out? --Never1-2 times a week3-4 times a week5 or more times a week

How would you describe your energy? -- How would you describe your energy? --Non ExistantVery LowAverage but wish I had moreI have bursts of energy and sluggish at certain times in the dayGood on energy

Does your body image of yourself affect your image? (spouse, family, friends, in public etc...) -- Does your body image of yourself affect your image? (spouse, family, friends, in public etc...) --YesNoAt times

When you look in the mirror tell me how you feel? And how you want to feel?

If you do not make changes now, where will you see yourself in 6 months or a year from now?

If you were to commit to the programs I have available (which are proven to get you results) where do you think you will be in 6 months to a year?

How are you motivated? -- How are you motivated? --Self MotivatedWords of Encouragement and PraisePrizesI don't want to lose money if I invest in a program. So I will do it!My health is a motivator because I need a change to improve my life and future

What is you reason for needing to take this step in improving your health?

On a scale of 1 - 5 how ready are you to improve your health? (1 being not ready, 5 being I need an intervention) On a scale of 1 - 5 how ready are you to improve your health? (1 being not ready, 5 being I need an intervention) 1 2 3 4 5

What are your goals?

Part of being in our virtual community is to be present and contribute. You get so much more support and encouragement by just encouraging others. How will you contribute to our community?

What makes you want to work with Lindsay and her virtual bootcamps?

Tell me about your support system. If you were to make some changes will those closest to you support you or not?

Even just one person to support you through this journey can make all the difference in the world. Lindsay is here but is there someone in your personal life that you could invite to join you and do this with you? Who?