Your Health Assessment

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Hi there! Thank you for your interest in getting healthier and/or jumping into my virtual bootcamp with me. I look forward to reading over your answers, assessing your needs, and building a customized plan for you!. I will be in contact soon. Look forward to connecting and working with you!

Blessings,
Amy

Email address *

What is your name? *

Are we friends on Facebook? *

Are you on Instagram? What is your handle?

Are you currently a Beachbody customer? *

Yes

Tell me about your current routine *

I exercise but its not consistent and I don't know what to eat.

I eat pretty healthy but I can't seem to lose weight.

I exercise and eat ok but I am not seeing results.

I am not doing anything yet! This is my first step.

I eat healthy and I exercise but I want to add to my routine and make it even better!

Other:

What is your current fitness goal? *

Weight Loss

Toning

Cross Training for endurance and Strength

Overall better health

Better eating habits

Other:

What obstacles are you facing when it comes to to your health and fitness? *

Do you use any supplements? *

yes

some days

Other:

Are you currently working with a coach? *

yes

When are you looking to get started? *

Would you be interested in learning more about getting your products paid for and helping other individuals by becoming a coach yourself? *

Yes

Maybe in the future

Are you ready for a change?

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