This Time I mean it conference call for weight loss

Conference Call Questionaire and Registration
Required Required Question(s)
Progress: 
 

Call for support!

Instructions:

With few exceptions, these questions are optional - but will help us provide a better experience. There are a maximum of 8 and the entire process should take no more than five minutes.


The only questions you cannot skip are:


1) Where did you hear about us? (helps us in our marketing)

2) Do you wish to attend? (directs you to registration if you click "yes")

3) Registration information (only if you wish to attend)


With the exception of registration information, everything is anonymous.

 

Date: Sunday, March 7, 2010 • Length: 90 min.

Cost: $24.95 prior to 3/1/2010 ($29.95 after that date)

Time call starts: 9AM PT, 10 AM MT, 11 AM CT, Noon ET

Includes loads of FREE Gifts!
 
Required

Please help us by telling us how you found out about this call.
From Dr. Denise Lamothe
From Rich DiGirolamo
From Scott "Q" Marcus
From more than one of above
Referred by friend
Internet Search
Don't know/don't remember
Other  
  • Comment:

  • 500 characters left.

Whether or not you attend this call, what would you like most out of a conference call like this?
 Don't Want This  Neutral  Really Want This 
Motivation & Support
Understanding why We Fail
Understanding of Habits
Specific Tips
General Information
Meet Like Minded People
Other (Please explain below)
  • Comment:

  • 500 characters left.

How do you measure success in dieting?
 Not at All  Neutral  Definately! 
A specific number on the scale
Other health numbers (blood pressure, cholesterol, etc.)
Different clothing size
Compliments from others
How I look
Lack of pain
Freedom of movement
More Active
Think Differently
Other (please explain)
  • Comment:

  • 500 characters left.

What's the number one issue you're dealing with in regards to weight loss?
Don't Know Where to Start
What I'm Doing Isn't Working Anymore
Lost my Motivation
Afraid I'll Give Up Before the End
Unsupportive People
Other  
  • Comment:

  • 500 characters left.

What keeps you up at night? When you wake up in the middle of the night and cannot go back to sleep concerned about your health; what causes it?
 

  • 350 characters left.

Any other comments you would like us to know that would help us provide more to those who attend the phone call?
 

  • 350 characters left.
Required

Do you wish to attend the call?

 

If you select "YES," you will be taken to a page where you can make your payment. If you do not enter that information, we will NOT be able to send you the call-in information nor be able to send you your free gifts after the call.


If you answer "NO," you will be directed to no more than two optional questions that will help us refine our information. Answers are anonymous.

 

NOTE: You will be added to our email list but you will not be spammed. You can unsubscribe any time you wish -- but of course, we hope you won't!
Yes
No