DREAM BODY QUESTIONNAIRE

Change starts with you, but I am excited to help you on your journey. By providing your information below, I will be able to design an effective, and most importantly a safe rewarding program that is personalized to fit your current goals.

*** PLEASE DO NOT FILL OUT THIS QUESTIONNAIRE UNLESS YOU WANT SERIOUS RESULTS IN 21 DAYS***
FULL NAME
PHONE
EMAIL
AGE/ HEIGHT/ CURRENT WEIGHT
MALE OR FEMALE
WHAT ARE YOUR HEALTH/FITNESS GOAL & WHY?
ARE YOU TAKING ANY DRUGS/ SUPPLEMENTS?
ON A SCALE OF 1-10, HOW COMMITTED ARE YOU TO ACHIEVING YOUR DREAM BODY?
DESCRIBE YOUR DREAM BODY IN DETAILS AND HOW WILL YOU FEEL WHEN YOU ACHIEVE IT?