Start here, I'm a...
Male
Female
What is your body type?
Block
Hourglass
Pear
Round
Triangle
What part of your body worries you the most?
Full - Mid section
Torso - Upper Body
Waist Line and Flanks
What is your body type? - Female
Block
Hourglass
Pear
Round
Triangle
What part of your body worries you most? - Female
Belly - Mid Section
Hips, Buttocks and Thighs
Lower body and Legs
How old are you?
Between 18 and 30 years old
Between 31 and 45 years old
45 years old or over
How much weight do you need to lose?
10 Pounds or less
10 to 20 Pounds
20 Pounds or more
What is your daily activity level?
Inactive – very little daily activity
Light – desk job with occasional walks
Moderate – active job or regular exercise
Active – Intense daily activity or exercise
What's the biggest struggle you face when it comes to losing weight?
I procrastinate
My lifestyle makes it hard to eat right
Diets are too hard to stick with
I have craving and am always hungry when dieting
Do you suffer from any of these issues?
Low self-esteem - I don’t feel good about myself
I don’t like the way my clothes fit
I don’t feel attractive
I need to lose weight for my Health
What is your reason or motivation for wanting to lose weight now?
I want to look and feel my best
Getting Married
Going on vacation / Getting ready for the beach
An important person in my life wants me to lose weight
Which time of the day do you feel the most tired?
Early to mid-morning
After lunch to mid afternoon
After dinner
Not until bedtime
Lastly, this may not seem like it matters, but "How many hours do you sleep at night?
Less than 6 or 7 hours most nights
7 or 8 hours every night
More that 8 hours at least 4 nights per week
Full Name
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Email
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