Confidence and Control 5 Day Challenge Form

Full Name *

Phone *

Email *

What is your main fitness goal right now? *

What is your current workout situation? *

I dont work out

1-2 x per week

3-4 x per week

5+ x per week

How would you rate your nutriton? *

Needs some work

Somewhat consistent

Very consistent

What is the biggest challenge stopping you from reaching your goals? *

What would success look like for you in the next 3-6 months? *

Have you invested in your health and fitness before? *

Personal Trainer

Online Coaching

Gym Memberships

Not yet, but open to it

Are you committed to showing up for yourself and completing the steps during the challenge? *

Yes 100%

I'll try but I am busy

Not sure yet

If you get great results and it feels right, are you open to hearing about continuing together after the challenge? *

Yes, absolutley

Possibly, depends

No, just here for the free challenge

Do you have the financial resources to invest in coaching if it is the right fit? *

Yes I can

Possible, if the time is right

Not right now