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Lifestyle Program Initial Form

We want to get to know you! Please tell us a little bit about yourself! 

Click the button below to start.

Start

Question 1 of 12

How did you hear about the Lifestyle Program?

Question 2 of 12

What is your current weight?

Question 3 of 12

What is your height? (feet & inches)

Question 4 of 12

What is your main goal?

A

Weight Loss

B

Muscle Gain

C

Tone up!!

Question 5 of 12

In terms of workouts, what level would you say you are currently at?

A

Beginner - give me easy workouts!

B

Home workouts (no gym available)

C

Intermediate, I have been in the weight room before

D

Experienced - smith machine? It's over there!

E

Advanced - I should be teaching you! (lmao)

Question 6 of 12

How many days a week do you CURRENTLY workout?

A

0

B

1

C

2-3

D

4

E

5+

Question 7 of 12

How many days do you WANT to workout? This is important for your workout plan build out (this can be adjusted in the future if you want to up your days a week you want to complete your workout)

A

2

B

3

C

4

D

5

E

6

Question 8 of 12

Please list all the places you currently work out at (home, gym, Pure Barre, OrangeTheory, Yoga).

Question 9 of 12

How long do you workout at the gym for (on average)

Question 10 of 12

What is the biggest struggle you've had in the past that you would like the Lifestyle Program to help you with?

Question 11 of 12

If you heard about the lifestyle program through a success coach, who was it? 

A

Angie (Okon Fitness)

B

Carmen

C

Cora

D

Desirae

E

Lizzie

F

Nikki

G

Sydney

Question 12 of 12

Can you commit to this program for 30 days, giving it your ALL? My promise to you is if you don't see progress over the next 30 days and you put in the WORK, I will refund you in full!

A

YES I CAN

B

No I can't

Confirm and Submit