Home
About
Contact
Blog
Recipes
Testimonials
Home
About
Contact
Blog
Recipes
Testimonials
Name
*
First Name
Last Name
Email Address
*
IG HANDLE
*
When is your birthday?
*
Did someone refer you to me? If so, please share their name with me so I can thank them personally!!
*
If you knew you would not fail, where would you ideally like to see yourself in 3 months?
*
Are you willing to invest in a fitness and nutrition program so that I may coach you towards achieve your goals?
*
YES!!!
NO
What are your health & fitness struggles currently? Please be specific. (Address digestive health, energy level, any weight loss/gain goals, hormonal balance, pain, inflammation, etc)
*
What are your biggest barriers to reaching your goals right now? Why have you not been successful in the past?
Give me a glimpse into your nutritional habits. Have you ever struggled with being an emotional/stress eater? Are you a chronic dieter? Do you feel guilty when you splurge? Do you have good self control when it comes to junk food/sweets? Any specific cravings?
*
Do you think you'd benefit from more structure in your nutrition program or more flexibility?
*
What is your current fitness level-- beginner, intermediate or advanced?
*
Would you be interested in doing a 3-Day Cleanse to jump start your metabolism and help banish belly bloat?
*
YES
NO
Please check which fitness equipment you have at home
*
Dumbells
Aerobics step
Pull Up bar
Exercise bands
Yoga Mat
Are you interested in Energize (Preworkout/My yellow juice) or Recover (Post workout)?
*
NEED IT!
NO
Are you interested in Beachbars? (Our clean-eating high protein snack bars)
*
YES
NO
What flavor of Shakeology would you like to try first? (This is what I refer to as "magical powder". It is incredibly nutrient dense and supports the body in several capacities with over 70 superfoods per serving. Flavors are Vanilla, chocolate, strawberry, cafe latte, greenberry -OR- Vegan flavors- Best for those with digestive sensitivities: Chocolate, vanilla, tropical strawberry, & cafe latte)
*
Are you interested in a wholesale/coach membership? (You can register for FREE to get all your supplements/goods at wholesale cost with a $15.95 monthly membership fee. Think Costco! Big savings!)
*
YES!
NO
Are you interested in joining our team of health coaches and building a business of your own? This can be as part-time or full-time as you'd like. We have everything set up for you to help you be successful! Our team is in the top 100 of the company and was named a 2019 ELITE X4 Team. We know how to make anyone successful whose willing to learn!
*
YES!!
NO
MAYBE
Can you share a little more about yourself? (relationship status, career field, a day in the life, the show you binge watch currently, what you do for fun)
*
If you would like to be considered as a participant of my next Bootcamp, comment "YES" below, and I will email information about the group within 48 hours of your application.
*
YES
NO
Thank you!
