Simply Human Reset Information Form
Last Name
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First Name
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Age
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Email address
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Re-Enter Email address
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Sex
Height
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Weight
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What is your occupation?
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Briefly describe your exercise habits.
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Briefly describe your daily movement patterns.
sit in a desk at work, constantly moving, etc...
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How many times do you eat grains in an average week?
How many times do you eat sugar in an average week?
Saturated fat causes high cholesterol and heart disease.
The only way to lose weight is to burn more calories than you consume.
Are you exposed to artificial white and blue light waves after dark on a consistent basis?
Being strict on a diet for 4 weeks then eating a cookie is "cheating."
Briefly describe your sleep habits.
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What is in your pantry right now?
Be honest.
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What is in your freezer/refrigerator right now?
Don't lie to me.
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How many times have you lost weight on a diet then gained most if not all of it back?
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How would you describe your tempermant?
When would you like to start the Simply Human Reset?
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Anything else you think I should know?
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If you have any other questions about the reset before signing up -- please email me: simplyhumanlifestyle@gmail.com
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