Help Me Help You Information Form Thank you for taking the first step to Begin Your Journey! I really appreciate you taking the time fill out this survey! It will help me to give you the very best I have to offer! It is through this survey that I will learn where you are in your wellness journey and how is the best way to serve you. Once you have submitted this survey I will be in touch with you via email and or text message to arrange a Free Turbo Coaching Call. Just imagine you and I are having a chat about your health goals as you answer these questions. Ready?? Lets get started writing the next chapter in your life! It's important to complete this form before the pre-coaching call. Full Name*Cell Phone Number*Email* Your Current Age*Date of Birth* Date Format: MM slash DD slash YYYY Your program can greatly vary depending on your ageWhat is your current weight and your goal weight?*Discuss your Fitness Goals in Detail with a DATE that you want to accomplish them by*How long have you been thinking about improving you health and wellness?*Why is it important to you to reach these goals now?*What has prevented you from starting sooner?*Is it still preventing you?*When did you last attain your ideal shape?*How did you FEEL when you were in your ideal shape?*How many days per week do you plan to exercise?*What time of day will you be exercising?*Where Do You Plan to Exercise*Home? Public Gym? Private Gym? Other?What type of program are you interested in?*One on One in person (Private)Small GroupFitness and nutrition coaching (via, phone, email or online)OtherWhat other program are you interested in?Imagine we will meet 6 months from now, what type of RESULTS would make you happy?*If you were to invest in a Fitness, Nutrition and Mindset Coach, what would you expect from your coach?*Select Your Preferred Date* Date Format: MM slash DD slash YYYY Select Your Preferred Time*7 AM8 AM9 AM10 AM11 AM12 PM1 PM2 PM3 PM4 PM5 PM6 PM7 PMI am aware that this program is not free*YesNoThank you for submitting your answers to this survey! We are very careful when choosing who we work with. Why? Because we have a very very high success rate with our programs. We promise to tell you at the end of your FREE Consulting Coaching Call. If we feel that we are a good fit! NameThis field is for validation purposes and should be left unchanged.