9bA8cj6.jpg

The first step is a decision.

"Change happens when the pain of remaining the same is greater than the pain of change"

-Tony Robbins

 
 

Transformation questionnaire

Congratulations on your decision to transform your life!  I look forward to learning more about you and the outcomes you are looking for.  Please fill out the questionnaire below in it's entirety.  This information is necessary in order for me to best serve you and guide you in the direction you desire to go.  Please note that this questionnaire needs to be completed before I can move forward in working with you.  

In order to maximize your results, it will be essential for you to follow the program and lifestyle guidelines, remain open and coachable and, take accept 100% ownership for your outcomes.

If you are ready to FULLY commit to transforming, let's get STARTED ...

 
Name *
Name
Phone: *
Phone:
Weight on the scale is not the most important factor in a physical transformation however, this provides us with an idea of the results you are looking for. We will be utilizing other methods of tracking your progress such as; measurements, progress photos and body composition.
Please list below the spiritual / inner work practices you have and how often you incorporate them.
What gives you the most excitement / joy / feelings of bliss / fulfillment.
If the answer is no, please explain why.
Please list any medical conditions, health concerns and/or medications you are currently taking.
Be sure to Include Snacks, Beverages and Supplements
Please provide an estimated amount for EACH separately.
Do you believe that your current nutrition and lifestyle habits are supporting the goals you listed above? *
I UNDERSTAND THAT I AM 100% RESPONSIBLE FOR MY RESULTS AND THAT MY LEVEL OF COMMITMENT IS WHAT WILL DETERMINE THE OUTCOME I HAVE. I AGREE TO BE COACHABLE AND TAKE 100% OWNERSHIP FOR MY RESULTS. *
EXERCISE DISCLAIMER: If you are taking part in any of our workout programs, please note that During your exercise program, every effort will be made to assure your safety. However, as with any exercise program, there are risks, including increased heart stress and the chance of musculoskeletal injuries. In committing to this program, you agree to assume responsibility for these risks and waive any possibility for personal damage. You also agree that, to your knowledge, you have no limiting physical conditions or disability that would preclude an exercise program. By checking the box below, you accept full responsibility for your results, own health and well-being AND you acknowledge an understanding that no responsibility is assumed by the leaders of the program. *