Please fill out the form below so we can prepare for your appointment.
Your Name *
Gender * MaleFemale
BEST EMAIL (PLEASE USE THE SAME AS YOU GAVE FOR THE APPOINTMENT BOOKING)*
PLEASE SELECT CALL PREFERENCE. PLEASE ALSO INDICATE IF YOU ARE AN INTERNATIONAL CALLER. * VIDEO SKYPE CALLAUDIO SKYPE CALLPHONE CALL
WERE YOU REFERRED TO US BY ONE OF OUR CLIENTS OR A COACH? HAVE YOU ALREADY PURCHASED ONE OF OUR PROGRAMS? IF SO, PLEASE SPECIFY THE PRIOR CLIENT'S NAME, THE COACHES NAME OR THE PROGRAM YOU HAVE ALREADY INVESTED IN. *
CURRENT WEIGHT *
TARGET WEIGHT *
WHAT DO YOU FEEL IS YOUR BIGGEST OBSTACLE TO HITTING YOUR TARGET WEIGHT? *
HOW WOULD YOU RATE YOUR FITNESS LEVEL * I am extreme beginner. I am new to trainingI have 6 months or more of fitness experience, but I am not always consistent.I am a fitness geek. I train more than 3 times per week and read a lot about fitness.I am a trainer and looking to learn more and be accountable for my own fitnessOther :
DO YOU HAVE ANY INJURIES? *
ARE YOU A VEGETARIAN OR VEGAN? * YesNo
HOW WOULD YOU RATE YOUR EATING HABITS? * I am a junk food fiend!I tend to jump from diet to diet.I am willing to keep a plan, but I cannot keep the weight off after the plan is done.I eat clean, but I have my vices.I eat SUPER clean.Other :
RIGHT NOW I... * Have significant financial resources to invest in reaching my target weight and bettering my health and am seriously ready to undergo a transformation,right now.Have the financial resources to invest in bettering my health, but I have never spent money on bettering my health and I am apprehensive to invest... However I really need to make a change!I am struggling to make ends meets and I don't have the financial resources to invest in bettering my health, but I really want to make this change and I am ready to commit.I don't have any financial resources at all & I was hoping for some free guidance.
IF SOMEONE ADVISED ME TO WORK OUT 3-4 TIMES A WEEK AND RETHINK MY EATING HABITS, I WOULD... * Know it's what any serious individual needs to do to lose weight and live healthier life.Would be a little intimidated, yet with a proven system I would do it because I'm serious about my health.Avoid it at all costs because I don't really want to change my habits.
OUR COACHING TEAM WILL CALL YOU AT THE TIME YOU CHOSE. PLEASE COMMIT TO YOUR APPOINTMENT BY TYPING THIS SENTENCE IN THE BOX BELOW: "YES, I PROMISE I WILL ANSWER THE PHONE FOR MY BREAKTHROUGH SESSION WHEN MY COACH CALLS. *
FINALLY, ON A SCALE OF 1 TO BRUCE LEE, HOW AWESOME ARE YOU? *
313 Datura St. #100 West Palm Beach
Phone Support: Monday -Friday 730am-5pm MST (317) 204-4848
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