VIP Access Health Survey
My VIP community is 100% complimentary with lifetime access.

My focus is on making lifelong lifestyle changes, so it's important I get to know your needs, goals and preferences.

Please fill out the form below and I will get back to you within 24-72 hours with a recommendation, full details and your next steps.

First and Last Name *
Your answer
Phone Number *
Your answer
Email *
Your answer
Location *
Current Fitness Level *
List any Beachbody programs you currently own. *
Your answer
Have you ever tried Shakeology? *
Do you have a Beachbody coach? *
What is your favorite workout style? *
How long would you prefer to workout each day? *
How is your home internet connection? *
On a scale of 1 to 10, how would you rate your nutrition? *
What equipment do you already have? (Ex. resistance bands, weights, yoga mats, medicine ball, etc) *
Your answer
Current Struggles (Check All That Apply) *
Do you have any injuries, workout restrictions or limitations? *
Your answer
Are you _______? *
What are your health & fitness goals? *
Your answer
What is your motivation? WHY do you want to achieve these goals? *
Your answer
Please describe your current workout routine and the results that you're getting. *
Your answer
What do you feel is stopping you from getting the results that you want? *
Your answer
Anything else you'd like me to know?
Your answer
When do you want to get started? *
Thank you for your responses! Are we friends on Facebook yet?
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