Consultation Smart Confirmation

Thank You For Requesting Your Free Blue Print Call!

Please Complete This Brief Questionnaire

Prior to the Call

First Name *

Last Name *

Email *

Phone *

What motivated you to connect with me?

Weight loss

Muscle gain

Improved energy

General health concerns

Current Weight

Ideal Weight

Age

Occupation

Do you have any health problems? Briefly explain:

What have you tried so far to improve your health/fitness?

How is not being in the shape you want to be in negatively affecting your life?

What happens if you don't reach your goals?

I do not provide cookie cutter or one off programs because they aren't effective. We'll be focusing on education and helping you achieve sustainable results for life. Are you willing to invest in a permanent solution?

Yes

Unsure

We will discuss the financial investment on our call - is there any reason you wouldn't be able to invest in a permanent solution for your long term fitness and health right now? (Buying a home/vacation/other large expense that prevents you from investing?)

Is there anyone else who might be involved in the decision making process?

When would you potentially be able to start if accepted?

Immediately

1-3 months

3+ months