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HEALTH AND FITNESS QUESTIONAIRE
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* Indicates required question
NAME
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Your answer
EMAIL
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Your answer
Phone number
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Your answer
CURRENT FITNESS LEVEL
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Your answer
PLEASE LIST ANY BEACHBODY PROGRAMS YOU CURRENTLY OWN
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Your answer
What's in Shakeology
HAVE YOU EVER TRIED SHAKEOLOGY
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YES
NO
DESCRIBE YOUR BEACHBODY COACH HISTORY
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I HAVE NEVER WORKED WITH A COACH BEFORE
I THINK I HAVE A COACH BUT WE HAVE NEVER COMMUNICATED
I USED TO BE A COACH BUT HAVE SINCE CANCELLED MY ACCOUNT AND AM NOT WORKING WITH A COACH
I HAVE A COACH THAT I WORK WITH
I AM A COACH
WHAT IS YOUR FAVORITE WORKOUT STYLE
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STRENGTH TRAINING
CARDIO/FAT BURNING
DANCE
EXTREME RESULTS
LOW IMPACT
HOW LONG WOULD YOU LIKE TO WORKOUT EACH DAY
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20-25
30-45
45-60+
Anywhere from 20-60+
LOW IMPACT
ON A SCALE OF 1-10 HOW WOULD YOU RATE YOUR NUTRITION (1 clueless and 10 a nutritionist)
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Your answer
WHAT ARE YOUR CURRENT STRUGGLES (Check any that apply)
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low energy
cravings
mood inconsistency
digestion problems
irregularity issues
immunity issues/getting sick
mental fog
not eating enough vegetables/greens
can't walk up stairs without getting winded
Required
Do you have any injuries or limitations
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Your answer
What are your fitness goals ?
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Your answer
What do you feel is stopping you from success?
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Your answer
Describe your WHY ( Your reason for creating better habits)
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Your answer
What motivates or inspires you?
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Your answer
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