New Client QuestionnairePlease enable JavaScript in your browser to complete this form.Name: *Phone:Can I text you?Yes, or course!Email *Do you want to be the first to know about new recipes and specials?Yes, add me to your email list and count me in!Website / Facebook / InstagramWhat are your goals? Be specific. *Why now? *What is your current wellness concern? *Physical fitness.Immune health.Hair, nail, & skin health.Better (more restful) sleep.Reduce stress.All of the above.Which option best describes your current diet? *Mostly plant based.I eat seafood/fish and dairy (pescitarian).I am a carnivore.Are you interested in becoming plant based?Yes!What are you most looking forward to with the 11 day detox? (Check all that apply) *Grocery list.Plant based recipes.Nutrition advise.Accountability for my diet/nutrition goals.Accountability for my fitness goals.A way to feel more in control of my own life (e.g., inspired, motivated, etc.).A safe place to share my journey.(Online) Personal training.I'm not interested in the 11 day detox.How would you describe your fitness level? *Beginner, I have never worked out before.Intermediate, I have worked out in the past but not recently.Expert, I currently work out 3-5 times a week.What does your current workout regime consist of? (Check all that apply.)Fitness classes (e.g., SoulCycle, yoga, boxing, etc.)Gym, free weights and machinesPersonal trainerRunning (on my own)WalkingOnline videosOtherCheck the statement(s) that apply to you... *I have tried a pre-workout in the past I do not currently use one.I use a pre-workout regularly.I have tried a protein shake in the past butI do not currently use one.I consume a protein shake regularly.I have tried a meal replacement shake in the past but I do not currently use one.I use a meal replacement shake regularly.I meal prep every week.I currently use a collagen product.I've never tried a collagen product but I'm infested in learning more.I currently take adaptogens.I've never tried adaptogens but I'm interested in learning more.Please list the products and workouts you have tried in the past (e.g., pre workout, BCAAs, personal trianing, etc.)What do you struggle with most.... *NutritionFitnessWhat do you struggle with the most in terms of nutrition?What do you struggle with the most in terms of fitness?When do you want to start? *August 23rdSeptember 1stNot sure.Do you consider yourself motived? Please explain. *What questions (if any) do you have for me?PhoneSubmit
