Welcome!
Please take a few minutes to fill out this ‘New Client Questionnaire' to help us understand how we can best support you!
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Email *
What is your full name? *
What is your mailing address? We have some gifts to ship to you!   *
What is your phone number? *
FOOD TRACKING & MACROS. Which statement best describes you? *
NUTRITION - Do you feel like you have patterns or eating less than you need, or patterns of eating too much?  *
Are you taking any medications or supplements? If so, please list and explain.  *
FITNESS. Describe your CURRENT WORKOUTS. How many days per week do you do resistance training? How much cardio do you do each week? What type of cardio do you do? *
FITNESS - Describe your CURRENT ACTIVITY LEVEL (not exercise related). For example: Do you hit a certain amount of steps per day? Are you seated most of the day? Do you walk the dogs for 15 minutes a day? Describe how active your daily lifestyle is.  *
How would you describe your level of experience with resistance training (lifting weights)? *
Do you prefer working out at home or the gym?  *
What type of work-out equipment do you have at home to be able to perform a workout? PLEASE LIST YOUR HOME WORKOUT EQUIPMENT if you want to work out at home.  *
Do you have any physical limitations? If yes, please elaborate. *
WATER - On average, how much water do you drink per day  *
SLEEP - On average, how many hours of sleep do you get in a night? And, how would you describe the quality of that sleep? Have you tried, or do you do anything specific to support your sleep? (Example: No screens 30 minutes before bed)  *
OVERALL STRESS - On a scale of 1-10, how would you describe your overall stress levels? (We realize this is a VERY general question, but do your best)  *
1 - Life is smooth sailing. My body is almost always in a calm state
10 - I experience chronic stress, and my nervous system is rarely relaxed
What would you estimate your ultimate goal weight is? *
What would you estimate your first milestone goal weight is? Breaking bigger goals down into 5 or 10 lb increments supports motivation. *
GOAL FEELING: Using 2-3 words, describe how you want your transformation to make you feel. *
WORK - What do you do for work? What’s your typically weekly work schedule? (This helps us understand your situation, time availability etc)  *
HOME ENVIRONMENT - Are you married/single/partnered? Do you have children? If so, how many, and how old are they? (Again, this helps us understand your situation & support you best)  *
What are your strengths when it comes to health & fitness? Are there certain things you already have good habits with or enjoy etc?  *
What are your biggest challenges or weaknesses when it comes to health & fitness? Any patterns or struggles that keep holding you back?  *
Please share anything else you think we should know/be aware of when crafting your training and nutrition plans!   *
Describe the ideal coach for you. What qualities do they have? For example: are they direct & strict to push you, or are they more gentle & empathetic in their support? Describe what do you need/want in order to bring your best!  *
What made you want to work with Jessica Joy & the Team? *
May I share your words and/or picture to celebrate progress and inspire others? *
If you could easily earn 50%+ of your program investment back through our ’Natural Referral Process,' how interested would you be in learning more? *
Are you ready to rock this, knowing you're going to change your body & life, and that you have all the support you need?! *
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