Optimal Life Coaching - Quick Survey
RequiredRequired Question(s)
Required 1.

What "Genius type" does it say you are?

Dynamo
Blaze
Tempo
Steel
Required 2.
Please provide your info. I would love to follow up with any insights I may find related to your "type" and how to best create health/weight loss success.

First Name:
Last Name:
Email Address:
emailaddress@xyz.com

Required 3.
What excites you MOST about being healthy? Be honest.
To get to wear more fun clothes and feel good in them
To feel like I have a more organized plan for meal times
To pass along healthier eating and/or exercise habits to my kids
To reach my goal weight on the scale
To improve my medical health
Other  
  • Comment:

  • 500 characters left.
Required 4.

What is your GREATEST challenge when it comes to creating health?

The amount of time it takes to plan ahead
Not wanting to miss out on social stuff that involves food and/or drinks
All the temptations at home or at work
Not seeing fast enough results
All the differing advice on what to do that will actually work
Other  
  • Comment:

  • 500 characters left.
Required 5.
What do you MOST want from a weight loss plan/program... besides quick results? (if you are not looking for a way to lose weight, click other.)
A proven system that is clear and easy to follow
Something convenient that doesn't require lots of prep
Caring, reliable support
Connection to other people in the same boat
Regular in-person accountability to a scale
Something that helps me get other areas of my life organized too
Other  
  • Comment:

  • 500 characters left.
THANK YOU!!