VIP Access Health Survey
My "HIP" (Health In Progress) VIP community is 100% complimentary with lifetime access.

Your only investment is a complete at home fitness and nutrition program that is yours to keep forever and will give you everything you need to start and achieve your transformation.

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? *
How did you find me? *
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?
If not, send me a request so I can message you directly there and you can message me with any questions:
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