First Name
*
Last Name
*
Phone
*
Email
*
Date of birth
What is your occupation? (this helps us determine your activity and stress levels)
What is your No. 1 health or fitness goal you wish to accomplish in the next 3-6 months? And how do you want to FEEL? What do you look like when you look in the mirror? BE SPECIFIC!
What have you tried in the past to achieve your goals? How has that worked for you? (The more details you give, the better equipped I am to solve your health/fitness problems)
In your opinion, what has been your biggest struggle in achieving your goals? Once again, please be very specific!
On a scale of 1-10 (1 being NOT IMPORTANT and 10 being EXTREMELY IMPORTANT),how important is it for you to overcome and achieve your goals?
1
2
3
4
5
6
7
8
9
10
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Please explain why you chose the number of stars (1-10) above.
Have you ever worked with a trainer/health coach before? If YES, what was your experience?
My programs are about teaching, not just ordering you around. I'll teach you everything you need to know to be in control of your health, fitness and confidence. Are you currently at a point in your life where you're ready and able to financially invest in yourself?
Yes, I have the financial resource to invest
No, but I am willing to get resourcefull if the program is good fit
No, I don't have the financial resource to invest
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How soon are you looking to get started with the program if it's a good fit? (Hint: if it's not right away, let's re-schedule for when you would be available to start)
Right away
Later
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In regard to investing in the program, is there anyone else who would need to be a part of the financial decision for you to move forward? (If your partner/spouse is involved in the financial decision, please either bring them on the call with you or have a conversation with them ahead of time.)
No, I am able to make my own financial decisions
Yes, but I will have it handled and talk to other person before the call
Yes, my partner is involved
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It's important you understand about our program and processes before we chat so you can make an informed decision on the call. Before we speak about the program, do you agree to spend a few minutes reviewing the program information sent over ahead of time so you can be best prepared for our call?
Yes
No
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Did someone refer you to the program? If so, please list the name below. If not, just type N/A
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