Waitlist Weightloss Questionaire
Please complete this questionnaire as honestly as you can. There are no right or wrong answers, and everything you share will be kept strictly confidential.
Email address *
Full Name *
Age *
Height *
What is your current body weight? *
How much weight would you like to lose? *
What other diets or cleanses have you tried in the past? (List specific diets) *
How often do you eat? *
Do you need to eat something in order to fall asleep faster or to sleep better at night? *
How would you rate your diet in the past month? *
Bad
Impeccable
How many hours do you normally sleep? *
Are there some foods that you can't resist eating or tend to overeat, even when full or not hungry *
When you indulge yourself with a food treat, such as chocolate cake or deep-fried chips, how do you feel? *
Why did you decide to ask me about weight loss? (Please describe what areas are of interest to you): *
Have you worked with a nutritional advisor in the past? *
Thank you!
Please submit your questionnaire, and book a 15 minute consultation with Aaron to discuss your situation
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