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Lifestyle Audit Form

Submit this form to receive personalized lifestyle suggestions for more energy, confidence, and lasting results

Name*

Email*

Country*

Brief message about what brought you here today

What are the lifestyle or self care goals do you need help with? *

What is your biggest STRUGGLE when it comes to getting the results you want? *

What would it mean to you if you achieved these goals? *

Which of the following best describes your fitness needs?

I like variety in my workouts so I'm never bored

I struggle with finding the time to make it to the gym or to workout consistently

I just need some MOTIVATION

I am on track with my fitness

Tell me a little about your current fitness level/ workout routine.

What types of workouts (if any) do you enjoy?

Which of these best describes your NUTRITIONAL NEEDS?

I need help getting back on track

I have no idea what to eat or how much

I struggle with uncontrollable cravings

I have a hard time making simple, healthy meals that also taste great

I eat well

Tell me about your daily nutrition, as detailed as possible (include any limitations like gluten free, vegetarian, etc):

How many times a week do you get takeout to save time/your sanity? This includes drive thru coffees, etc.

5+

3-4

1-2

0

Now the fun part! Tell me a little bit about you and your life so I can make sure our plan fits in with the demands and interests of everyday life. *