Where to start?

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Where to start?

Here is a survey that will help determine which program may be a good fit for you. The questions focus on meal plans, monthly coaching, and daily accountability. Once you have answered the questions, Kristin will help you determine in more detail the best approach for you to move forward.

Email *

Name *

phone number *

Do you enjoy cooking? *

Yes

Other:

Are you willing to make time for cooking. *

Yes

Other:

Are you willing to eat leftovers. *

Yes

Other:

Are you willing to pack a lunch. *

Yes

Other:

Do you have dietary restrictions? *

Do you generally eat well? *

Yes

Other:

Do you eat a lot of fast food? *

1-2x/week

2-3x/week

Once in a blue moon

Other:

Do you stress eat? *

Yes

Other:

Are you willing to follow directions? *

Yes

Other:

Are you in a hurry to lose weight? *

Yes

Other:

Do you need a lot of accountability? *

Yes

Other:

Are you always on the go? *

Yes

Other:

What is your general opinion of yourself *

Why bother...

I'm worth it.

Other:

Are you ready to make the necessary changes to your nutrition lifestyle? *

Yes

Other:

Thank you!

You will be hearing from Kristin soon!

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Boutique Fitness. Report Abuse

Forms