Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Contact information
Let's See If We are a Fit!!! 🧘🏻🧘🏻🧘🏻 Health Food Challenge Form 🧘🏻🧘🏻🧘🏻 Let's eat clean!
* Indicates required question
Welcome and Thank you for taking the first step! You can do this!!!
Please fill in this form and be totally honest. Thank you!
🧘🏻🧘🏻🧘🏻 Ann Hyland's Health & Fitness Challenge 🧘🏻🧘🏻🧘🏻
Remind Yourself: This will be a journey. It will take time. One day at a time.
YOUR FULL Name
*
Your answer
YOUR Facebook URL, Instagram URL? EX:
https://www.facebook.com/annhylandnow
https://www.instagram.com/annhylandnow/
*
YOUR Facebook URL
YOUR Instagram URL
YOUR Linkedin URL
I don't do social media
Other:
Required
What is your SHORT & LONG term health food goals?
*
Your answer
How would you describe your CURRENT eating habits? Check all that apply.
*
I have food allergies
Just eat whatever I want without consequences
I eat meat and potatoes mostly
I eat vegetarian sometimes
I prefer eating raw and vegan
I eat kosher
I enjoy drinking smoothies and shakes
Other:
Required
Have YOU ever hired health coach or chef before?
*
Yes
No
Are you ready to commit to online video calls at home?
*
ABSOLUTELY!!! YES!!!
No
I am not sure
Have you ever worked with a COACH or are you currently working with a COACH? Check all that apply.
*
YES I have worked with a Coach before
YES I am working with a Health Coach/Chef/Nutritionist
NO I have not worked with a coach before
Required
Be totally honest. No judgement here. Let's get REAL! What does YOUR NORMAL day of eating look like for you? Check all that apply.
*
I eat Fast food
I eat out from restaurants/carry out
I prepare my own food and I overeat
I prepare my own food and I eat healthy portion controlled meals
I drink a healthy protein energy shake
I skip meals and I don't eat
I go on crazy food binges
I am completely off the chain overeating
I keep a kosher kitchen
Other:
Required
What are you currently doing for exercise? How is it working? This info really helps me to help you!!! Check all that apply.
*
I am not exercising at all.
I am rehabbing an injury and working out is difficult for me.
I just walk in my neighborhood
I lift weights
I practice yoga and stretch
I practice pilates and barre exercises
I love to dance
I have a exercise program that I love and works for me
I am very happy with my results from my exercise program
I really need to lose weight
I really need recipes
I really need support and accountability
Required
What is your biggest obstacle to get the results that you want? (Be specific)
*
Your answer
Do you have any restrictions or limitations? (Share your injuries)
*
Your answer
Your CURRENT struggles? Check all that apply
*
Motivation
Stress
Accountability
Money
Emotional and Binge Eating and Cravings
Meal Preparation
I need Recipes
No energy
Portion Control
Time
Commitment
I Don't Know Where to Start. I'm Overwhelmed.
my kids and husband don't eat way I like to eat
Other:
Required
Any Questions for me?
Your answer
***WHEN do you want to START?
*
Today, Let's do this and YES, Reserve My Spot!!! I am ready to invest now!
I'm about ready, just have a few questions. I want to talk on phone directly with Coach.
Unfortunately, money is tight, I have to wait until next month. Call me in a month
The Journey to Health & Fitness is a Process!!! Join me!
I'm sooooooo excited to be your Coach!!!! I am a Life Coach, Health Coach, Yoga Coach, Raw Vegan Chef Coach, Simplifying and LettingGo Coach. My journey has been a much longer than I imagined. I survived a head on car accident with a drunk driver and I am alive and yes I have injuries!!! I've lost an entire person in weight (167 pounds gone!!!). I retrained my brain and regained skills after learning I have a traumatic brain injury. I have been in terrible relationships attracted my soul mate, and then my fiance died!!!! I have lost businesses previously and I am thriving in transforming all my business visions, one day at a time. I am here for you in your journey, wherever it takes you in Life, Health and Fitness. No Matter What, You Can Do This! You may crawl as a caterpillar at first (or along your journey if you have injuries, like me) and this is all ok. And soon with persistence and consistency you will be flying high like the beautiful butterfly that you already are soaring in adventures, beyond what you ever imagined with your new health and fitness lifestyle. Join me and my team of amazing coaches to get started, motivated, and get transformed and build a life of integrity now. Namaste 🙏 I am ready to book an appointment with Ann as my Coach now... Goto
https://calendly.com/yogabutterfly
. Call or text 443-322-4408 RE I am ready now.
Your answer
Comments
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report