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Choose Your Own Adventure Program (End the Inner Critic and Find Your Inner Champion)
Please answer all questions for the best program customization.
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Name
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
What is your main reason for interest?
*
Weight
Body Image
Both
Other:
How does this challenge impact your life, your friends, and/or your family?
*
Your answer
What have you tried for help, starting with the most recent?
*
Your answer
What are your NSV (Non-Scale Victories) that you most desire when you picture achieving your goal?
*
Your answer
What do you think is stopping you from achieving your goal?
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Your answer
If you could think of one thing that would make your custom program all worthwhile, what would it be?
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Your answer
What is your preference that would make you most likely to succeed?
*
Self-paced program
One to one coaching sessions
Group support with the program
Self-paced with accountability daily
Self-paced with accountability weekly
Self-paced - don't call me, I'll call you
What is your best way to learn something new?
*
If I hear the information, I'm good.
I'm a visual learner.
I need to be shown how to do it, and try it out.
Other:
Are ready to make the investment of time and money for the right program?
*
Yes
No
Do you currently take supplements or medication?
*
Yes
No
If yes, please provide names (or have info ready when your program begins)
Your answer
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