The Healthy Gut Club New Client Application

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Please fill out this form only if you are seriously interested in working with The Healthy Gut Club.

Once the form is submitted, you will be prompted a link to book a complimentary call with a HG Club client coordinator.

Please do not forget to click the link.

Thank you!

Email *

What's your first and last name?

What's your phone number? *

Where are you located? *

How did you hear about The Healthy Gut Club? *

Instagram

TikTok

YouTube

The HG Club Website

Referred by a friend/family member

Other:

I understand the purpose of this call is to take the next step in working with The HG Club. I understand this call is NOT to gather free information about an issue I am struggling with. *

Yes

What is your main reason for reaching out to The Healthy Gut Club? *

On a scale of 1-5, how motivated are you to improve your health? *

Could not care less

Need to make a change now

What's been the biggest obstacle preventing you from improving your health? *

The Gut Healing Program is a 6 month program. Are you ready to commit to this? *

Yes

Are you planning on becoming pregnant within the next 6 months?

Yes

Maybe

Other:

Clear selection

I understand I will be placed with a HG Club practitioner that best matches my goals and personality. *

Yes

What is your current job and how many hours do you work per week (on average)? *

What is your annual household income? *

<30K

30-50k

50-70k

70-90k

100k>

Are you in a good place financially to invest in your health? *

Yes

Are you in a good place mentally and emotionally to invest in your health? *

Yes

Working with the HG Club is an investment. We offer different payment plans of $299, $399 and $599 per month for 6 months. Are any of these options in your monthly budget? *

Yes

Is there anything else health related our HG Club Client Coordinator should know that was not yet mentioned?

Will you be in a place that allows you to be full present during our call (ie no distractions)? *

Yes

After this form is submitted, you will be prompted to a link which will allow you to schedule a call with a HG Club client coordinator. *

Great, I won't forget to click the link after I submit this form to schedule a call

I do not want to schedule a call

IMPORTANT: Please do not forget to click the link on the next page to schedule your complimentary call!

Send me a copy of my responses.

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