Welcome! I'm so glad you're here.
You've taken the first step in making YOU a priority in your life. I am excited to offer you the support and accountability you will need in order to commit to a long-term healthy lifestyle and the tools to reclaim your personal power. In order for me to truly serve you at the highest level, please complete this form so I can better understand where you stand now with your goals and where you see yourself going next. This questionnaire is merely a tool I use to help me get a grasp of your strengths and weaknesses so that I can pair you with the program that will be the best fit for you. Your responses are confidential and only used by me for this purpose. I can't wait to know you! Let's get started. ~ Barbie
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Email address
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Your email
First Name
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Your answer
Last Name
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Your answer
Phone Number with area code
Your answer
How do you prefer to be contacted?
Email
Phone
Other:
Instagram Name
Your answer
Facebook URL
Your answer
Location
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USA
Canada
U.K.
France
Tell me what you want to accomplish & why
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Your answer
How long have you wanted to make this change?
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Your answer
What have you tried in the past and what did you like/dislike?
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Your answer
Why did it fail for you (or what got you off track now)?
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Your answer
What kind of support system do you have in place?
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Zero - I need support
My family/friends are not supportive at all
My family is supportive but doesn't want to make changes too
My family in 100% on board and wants a healthy lifestyle change
Other:
How is your energy level?
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I'm sluggish and tired and need caffeine to keep going
I'm tired mostly when I don't get enough sleep
I'm a natural energizer bunny
Not sure
Where would you rate your fitness level?
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Beginner
Intermediate
Advanced
Other:
Are you already working with a Beachbody Coach?
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Yes (Please explain in the Other box below).
No, not at all.
Other:
How did you find me?
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Facebook
Instagram
Friend
Blog
Other
Other:
Is there anything else you'd like me to know before we talk?
Your answer
A copy of your responses will be emailed to the address you provided.
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