Sign in to your Google account to fill out this form
This form contains features which require sign in. Your identity will not be revealed.
Responses cannot be edited
I'm so proud of you! You are no longer "wanting to start" your fitness journey, but just started! This is your first step. Congratulations!
I'm so glad you're here, taking this step, moving forward toward your goal of wellness. Please be honest and know that I respect your privacy. I care about you and your journey. Let's work together and find the right tools and encouragement group for you.
Facebook Profile URL: (so we can be friends!)
Where are you on your fitness journey?
This is my first step!
I have tried things in the past, but need some encouragement and learn about a program that may fit me best.
I've been consistently exercsising and watching what I eat, I just want to tone up more.
I've been consistently exercising and eating healthy, I just can't seem to lose weight.
Do you currently have a Beachbody Coach?
No, I'd love to work with you!
Yes, you are my coach.
Yes. It is someone else. I'll check with them to see what they are doing!
Have you ever tried Shakeology?
Never. / What's Shakeology?
I have tried it, but am not a current consumer.
I own some, but do not have it as a part of my daily routine.
I drink it everyday!
What's your biggest hurdle to overcome with exercise?
What type of Exercises appeal to you the most from this list?
Mixture of weights and cardio
I'm not sure.
Do you recognize that it is best to run by your doctor any program recommended?
What's your biggest hurdle to overcome when it comes to food?
How are you at portion control? Healthy food choices?
I need help finding healthy recipes that are simple.
I need help with portion control.
I'm not sure where to start. I'm feeling overwhelmed and need to find something that I can keep up with long term.
I'm great, but would love to keep up with some great recipes on the blog.
I would love to join a challenge group limited to 5 people on Facebook. I want private accountability when I post my daily wins and struggles.
I'd like to join a large accountability group because I'd rather not post, but find encouragement from others.
I'd like to try an app on my phone for the next accountability group starting. I'd rather not login to Facebook to keep track of my accountability group.
I'd rather not be an accountability group, but know that I can message anytime to join in on one!
What is your goal for the next 30 days?
What is your long-term health goal?
Are you interested in saving money? Encouraging others? Working closely with me?
Maybe later I'd be interested in saving money and getting a discount on items purchased by becoming a "discount coach".
Can you tell me more about this?
I'm not sure if coaching is for me. Can you tell me more?
I'd love to purchase at a discount and be able to encourage others through my own personal journey to wellness. Will you contact me please?
What else would you like me to know?
I am honored and humbled that you are joining me. Thank you for your time.
I look forward to celebrating your steps to health. Please be sure to find me on Facebook, and my blogs to keep up with sale items, recipes, encouragement, and announcements!
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service