Madi Still’s “Be Healthy” intake survey
Hi! Thanks for completing this form for me :-)
On a scale of 1-5, how close are you to your ideal weight?
I'm FAR from my weight
I've reached my ideal weight
How much weight would you like to lose in the next 90 days?
up to 10 lbs
up to 20lbs
up to 30lbs
I need to GAIN weight
Are you interested in trying Herbalife to reach your health goals?
for 3 days
for 14 days
for 30 days
No, not interested
If you answered "not interested" what is your reasoning?
I didn't like the products I tried
I'm not committed to doing a program at the moment
What supplements do you think you'd benefit from?
None of the above
What would you benefit from?
weekly weigh ins
a group for accountability and support
daily motivating text messages
a weekly nutrition lesson
all the above
none of the above
Would you like to discuss getting your products for a higher discount or for free?
Is there anything else I should know about you?
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