What Do You REALLY Want?

Name

First Last

Please leave your full name.

Do you work full-time?

How stressed do you consider yourself throughout your usual work week?

How many times per week do you exercise?

How many hours of sleep do you average per night?

How many days per week do you eat healthy?

What is it you specifically want from this program? What results or outcomes?

How much weight loss do you specifically want? What areas of the body would you like to change?

If you achieve the above, what will it do for you?

What are your 3 biggest problems, frustrations or fears keeping you from achieving the previously mentioned goals?

What do you worry might happen?

What are you secretly worried about? What are you not telling anyone?

Tell me more about yourself. What else would you like me to know?