Summer SlimDown

With any health program, there should never be an END but this is a jump start to the rest of your life! I want serious people who are ready to make a change once and for all! Once I receive your information, I will be in touch to complete the process. You will receive a shopping list, a menu  you will also receive a cardio plan and a training piece too.. its amazing. Can’t wait for you to experience it for yourself!!!

I was able to get through the past two nights of dinner (or I should say others’ dinners) without caving or even an URGE to cave on the Detox! Monday night I made one of my favorite meals for my boyfriend for dinner and did not even sneak a bite and last night they had one my favorite meals at work – had to prepare the meals for my six group members and watch them eat, but I was FINE! This is not normal for me! Normal would be me going crazy and fighting like hell not to cave! — Kasey M.

Name *

City and State

Email Address *

Phone *

Birthday *

Height

Weight

Do you current use protein supplements?

Yes

No

If yes, please list what brand(s).

Have you followed any specific nutrition program in the past? If so, were you successful?

Describe your current nutrition- on a scale of 1-10 (10 being the best).. how healthy is it?

Do you count calories?

Yes

No

Do you measure food?

Yes

No

How much water do you drink each day?

How much sleep do you get each night?

On a scale of 1-10 (10 being the worst), what is your stress level?

What do you do for work?

Do you have any food allergies?

Yes

No

If yes, please list them.

Have you ever had any issues with food?

Yes

No

If yes, please describe.

Are you on any medication?

Yes

No

If yes, please list them.

Do you have any injuries or illnesses? If yes, please describe:

How often do you work out each week?

What's the one thing do you'd like ot get out of this program? *

What is your biggest challenge right now? *

On a scale of 1-5 how commited are you to achieving your goals. 5-- hell yes 1 - not so much *

1

2

3

4

5

How did you hear about this program?

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