A 28 Day Online Food and Fitness Accountability Group
Home Address (I might send some happy mail)
Who referred you?
Which phase are you the most intersted in?
Phase 1: Weight Loss
Phase 2: Maintenance
Phase 3: Strength Building
What are some of your health goals?
Lose 10-15 lbs.
Lose 16-30 lbs.
Control my eating
Improve lab results (cholestrol, blood pressure, etc.)
Maintain or gain weight
Manage mood swings
Name one person who will help hold you accountable to your goals:
What is your start weight?
Getting your start weight and measurements are essential for tracking your progress. Please submit your information below.
Did you take your before picture?
Measurements: Right Arm
Measurements: Left Arm
Measurements: Right Thigh
Measurements: Left Thigh
Measurements: Right Calf
Measurements: Left Calf
The online accountability group is a private FB page. Are you willing to be added and participate? Type your intials below.
Your participation, comments, and updates are important to the success of the group.
Send me a copy of my responses.
Please complete the captcha before submitting the form.
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