Your Dreams and Goals
Hello, and WELCOME to this Self-Awareness Form that will give us a base for our conversation. It will tell both you and me where you've been, where you are, and where you want to be with your IdealWeight! Once I receive it back, I'll call you within 24 hours so we can visit and see if "8 to Your IdealWeight" is a good fit for your needs. I look forward to our call!
Email address *
Name *
Your answer
Phone Number & Time Zone (Central/Eastern etc.) *
Your answer
Why are you wanting to lose weight NOW? *
Your answer
What specific challenges is your extra weight causing you? What are you missing out on? *
Your answer
What have you tried recently that HASN'T worked? *
Your answer
What kind of processes/programs do you prefer? Check all that apply. *
Required
How much time are you willing to invest each week on Coaching/Conference Calls/Journaling? (Please note that a Facebook account is required for some of the program options.) *
Required
What days of the week work best for you for a Coaching Call or a Group Meeting? (Select at least 2) *
Required
When would you like to get started? *
How will it feel to be at your IdealWeight, have your daily food decisions be easy, never be hungry, and regain your energy and confidence? *
Your answer
How did you hear about IdealWeight? I am grateful you reached out, tell me how you found me? *
Your answer
We will be mailing you your Personal Journal if you decide to invest in one of these levels. Please share your address below with the understanding it will NOT be used for marketing. *
Your answer
Let's set up a 20-30 minute phone call so I can answer all your questions about "8 to Your IdealWeight" and together we'll see if this program is a fit for your lifestyle. When would be two good times in the coming week? I'll confirm back with you the time for our call. I am looking forward to connecting with you! *
Your answer
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