Health Goals Survey

What Health/Fitness/Nutrition goals do you want to accomplish over the first 30-60 days of 2019? Be as specific (and realistic) as possible.*

What Health/Fitness/Nutrition goals do you want to accomplish over the course of the entire year? Be as specific as possible.*

At the moment, what are you struggling with the most in regards to making your health a priority?*

What do you feel you need help with the MOST in order to reach your health goals?*

Are you currently using Beachbody on Demand (BOD) to stream your workouts at home?*
- Yes
- No
If not, would you like more information on BOD and how it can help you reach your fitness goals at home?*
- Yes, please send me more info.
- No, I'm not interested at this time.
- I've tried it before.
Do you plan to continue using BOD as part of your wellness plan in 2019?*
- Yes
- No
What was your experience like when you tried BOD? What did you like or dislike about it?*

Are you currently drinking Shakeology?*
- Yes
- No
- Sometimes
If not, would you like more information about Shakeology?*
- Yes, please send me more info.
- No, I'm not interested at this time.
- I've tried it before.
Do you plan to continue drinking Shakeology as part of your wellness plan in 2019?*
- Yes
- No
- I'm not sure
What was your experience when you drank Shakeology? What did you like or dislike about it?*

Do you know someone who could benefit from health coaching? Please feel free to send them my contant info below or include their's below and I will follow up with them.
Rachel Freebairn
Online Health and Fitness Coach
847-951-2373
freebairnr@gmail.com
www.rachelffitness.com
What could I do differently in the future to help serve you better or improve my services?*