Initial Health Evaluation Form
Our Intentionally HIS community is 100% complimentary with lifetime access.
Your ONLY investment is the complete home workout program and nutrition bundle that is yours to keep forever that will give you all the steps you need to start and achieve your transformation. My focus is life long results and lifestyle CHANGES, so it's important that I get to know your needs, goals and preferences.
Fill out the form below and I'll make sure to get back to you in the next 24-72 hours with a recommendation, full details and your next steps! Glad to start this journey WITH you!
Best Email Address
Current Fitness level
List any Beachbody Programs you currently own:
Have you ever tried Shakeology?
I have never tried Shakeology- what is that?
I have tried it in the past and liked it but am not currently having it
I have tried it in the past and didn't like it
I drink Shakeology everyday- I love it!
Have you ever had a Beachbody coach before?
I have never worked with a beachbody coach before
I think I have a Beachbody coach but we have never communicated
I currently have a Beachbody coach
Who referred you?
What is your favorite workout style? (select all that apply)
Cardio/ fat burning
Extreme programs for extreme results
What is your movement preference?
I prefer easy to follow exercises that repeat
I can easily pick up moves and can follow choreography
How long would you like to workout each day? *
On a scale from 1-10, how would you rate your current nutrition?
What's wrong with Ice cream for breakfast?
I'm obsessed with nutrition!
What workout equipment do you currently have? (EX: Weights, Resistance Bands, Yoga Mat, Medicine Balls, treadmill, etc.)
Current Struggles You're Facing:
Feeling like I'm worth it
Portion sizes of food
I don't know how to say no to food
Do you have any injuries or limitations?
None of the above
What are your short term (could achieve in 1 month) health goals?
What are your long term (could achieve in 1 year) health goals?
Describe your current workout & food routine and the results that you're getting.
What do you feel is stopping you from getting the results that you want?
When do you want to get started?
Next month's challenge group- I'm ready to start the program that's right for me!
Not quite ready, I have some reservations that I would like to talk with you about
In a few months so I can save up money and invest fully in the program to get the results I want!
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