Please fill out this form before your first visit!
What is the best method to contact you?
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Who referred you to our support/challenge group?
What would be the best way for us to support you during your health journey?
Private Facebook Support Groups
Have you purchased a fitness/nutrition program? If so, which one?
What's your fitness level?
Beginner – I have not worked out in a long time or ever.
Intermediate – I exercise on occasion or have done so in the past
Advanced – I am physically fit and want to change
My nutrition can be characterized as:
I only eat junk food
I eat healthy 25% of the time
I eat healthy 50% of the time
I keep healthy 75% of the time
My nutrition is perfect
I want to lose:
5 to 15 pounds
15 to 30 pounds
30 to 45 pounds
Please describe what efforts you have taken to lose weight in the past (if applicable). If those efforts were not successful, please share why do you feel you failed.
Would you be willing to dedicate time each day to plan your meals?
Would you consider using a whole food meal replacement daily?
Are there any medical conditions that you are currently dealing with that may affect your ability to participate in any fitness/nutrition program?
Tell me your personal goals with regards to your health and wellness.
My main priority is to
I have a particular Team Renewal Coach that I would like to work with.
If so, which coach?