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1:1 Consulting with freelee
Application form
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Freelee here. I’m excited to work with you and assist you in gaining the results you dream of. Please fill in the following form so I can get to know you better.
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Email
*
Your email
Name
*
Your answer
Location/Timezone
*
Your answer
Age
*
Your answer
Height
*
Your answer
Weight in lbs
*
Your answer
Tell me more about your weight, whether it fluctuates or not, etc:
*
Your answer
Occupation (include work hours, travel etc.)
*
Your answer
What other plans or coaching have you tried? What worked? What didn't?
*
Your answer
How did you find Freelee?
Instagram
YouTube
Google search
Friend suggestion
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What is your Instagram page?
Your answer
Have you had any weight loss surgeries?
YES
NO
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If yes, which surgery?
Your answer
Are you on any medication? Or do you plan to take any?
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YES
NO
If yes (Medication), which ones
Your answer
Do you exercise?
*
YES
NO
If yes, what exercise, how often & for how long each week?
Your answer
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