First Name
Last Name
Email
*
Phone
*
Are you committed to working out 3x per week?
*
Yes
No
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Are you in good general condition with your health?
*
Yes
No
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What injuries do you have that may hinder your progress?
*
How may I help you?
*
Weight loss
Become more athletic/feel stronger
Tone/body fat loss
Weight gain
Increase Mobility
Other
What's your dream goal in regards to your health?
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How Long have you wanted/have been trying to achieve this goal?
*
What's your WHY behind this/Why do you want this so badly?
*
What if anything has been holding you back from achieving your goals?
*
Why do you think you'll succeed this time?
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Is it more important that you lose the weight quickly or permanently?
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Quickly
Permanently
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Are you financially able to invest between $49-$124 per week in yourself to achieve this goal?
Yes, If it's the right fit I'm financially willing to invest in myself
Maybe, it would take some sacrifices in my budget
No, This is not currently in my budget
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Do you solely make the financial decisions when it comes to your health?
*
Yes, I make the financial decisions when it comes to my health
No, I would need to consult with my significant other
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I agree to
terms & conditions
provided by the company. By providing my phone number, I agree to receive text messages from the business.
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