JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
ALL ABOUT YOU
Sign in to Google
to save your progress.
Learn more
What is your first and last name? .... Jessica trice
Your answer
Who told you about the MIND.BODY.SUMMER challenge? What is the name (first AND last OR ig handle) of the coach? Are you already working with another coach? This is VERY important- this is the person in charge of reviewing your quiz and sending your results & plan.... Brittney Graff
Your answer
What do you need the most help with?
Food
Exercise 📌
Life structure/scheduling: Getting it all in
Clear selection
What is your relationship with exercise?
I have never enjoyed exercise or sweating but I know I need it.
I used to exercise consistently and love it but I now struggle with consistency & long term commitment.
I exercise at least 3 times a week and have for a very long time.
I recently started a consistent exercise routine but need the accountability & help to keep it going long term.
Are there any types of exercise you really DISLIKE?
Your answer
What is your current nutrition like?
ON POINT! I don't' need any help with nutrition.
It's a mess. I need both education & a plan.
It's ok... I mostly know what to do but I just don't do it.
I eat clean-ish but need help losing weight or reaching a physique goal.
I'm such a picky eater- I hate veggies.
I have tons of food intolerances.
Clear selection
What are your main goals?
Lose weight by a certain date/season.
Lose weight but no timeline. I'm ok with it being slow and steady if it lasts.
Maintain weight but see more definition & improve health.
Gain weight & muscle.
Clear selection
What things prevent you from working out consistently?
Low energy. Always feel like I need to conserve energy or don't have enough to start.
The time it takes. I feel like there is no extra time in my day.
Too much work to get out of the house to the gym or a class.
I like to have community and people to exercise with.
Laziness
It doesn't feel good.
Clear selection
If you had a magic health genie what would they give you?
A personal trainer that would come to my house every day.
Ice cream that was healthy and made me lose weight.
A personal nutritionist to teach me all they know and give me meal plans.
Magical snacks that tasted like candy bars & junk food but helped me lose weight and get sick less.
A list of things that were tripping up my weightloss and health journey- foods that my body loved and hated, all the little quirks in my body that tripped me up.
Clear selection
What is your Instagram or Facebook account/handle?
Your answer
Email?
Your answer
What do you struggle with?
Working out consistently.
Not getting discouraged or giving up.
How I feel about myself.
Sweets & Treats
Nighttime eating
Knowing what to eat.
How much I eat.
Following a meal plan.
Healthy snacks
How long it takes to cook healthy food.
Clear selection
What are your top 2 priorities?
Losing weight
My overall health- changing my eating
Staying within my budget
Detoxing
Learning how to eat for results and health
Challenging myself
Slimming & toning
Stopping my sugar and junk food addiction
Getting support and accountability
Clear selection
What budget would you like to stay within for this challenge? We have options to fit every budget.
I just want something free- not willing to invest in myself this way.
$30-$50
$100-$200
$250-$450
Price doesn't matter if it's going to get me where I want to go.
Clear selection
Do you have any health concerns like thyroid, adrenals, high cholesterol, blood sugar levels, PCOS, auto-immune disease?
Your answer
Anything else we should know?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report