Tell Me About You
New Client Questionnaire
Name and Birthdate
Are you a Beachbody Coach or currently working with another Beachbody Coach?
What is your primary reason for having some interest in this group?
Learn how to eat healthy
Improve a health condition (diabetes, high blood pressure, cholesterol, IBS)
Boost your immune system
How much time PER DAY do you spend exercising right now?
Less than 30 minutes
More than 60 minutes
How many days per week do you exercise?
How would you rate your nutrition and current daily diet plan?
Need a lot of help here
Are you willing to check in 1x day on our Virtual Gym group and commit to posting/participating daily to track your progress?
Keep in in mind for your next group
List any health concerns/conditions that you are experiencing:
Diabetes, high blood pressure, joint pain or other injuries that will affect your ability to exercise
List your most important, most realistic goal that you would like to achieve by the end of our first 30 days together.
What will reaching these goals mean to you? Don't hold back!
What have you done in the past that worked well for you?
Where do you envision yourself in 5 years? Dream big here!
What if you decide to do nothing today? How will you feel in 5 years if nothing changes?
One of the requirements of this group is to replace 1 meal a day with a healthy (no artificial ingredients) meal replacement shake that contains a decent amount of protein. These challenge groups have been run for several years and the most successful people have made the committment to an exercise program and Shakeology. If you choose to not use the Shakeology, please list the name of the shake below you will be using.
Answer NA if you will be using Shakeology
Do you have any Beachbody products at home currently? If so, list them below.
P90, 21 day fix, Insanity, Piyo, etc...
If you lose your way during the challenge, what is the best way I can bring you back?
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