2B Mindset Support Group
RequiredRequired Question(s)
1.
Please enter the information indicated below.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Email Address:
emailaddress@xyz.com
Address 1:
City:
State/Province
(US/Canada):
Postal Code:
Country:
Cell Number:

Required 2.

Have you participated in a health and fitness accountability or support group before?


Yes
No
  • Comment:

  • 500 characters left.
Required 3.

Do you currently have Beachbody on Demand?


Yes
No
  • Comment:

  • 500 characters left.
Required 4.

How would you describe your currently nutritional status?  (Please base your response on consistency over the past 6 months)

Poor (i.e., mostly processed foods, eat out multiple times per week, sugary beverages daily, very few whole foods)
Fair (i.e., eat mostly whole foods, some processed, eat several servings of fresh fruits and vegetable weekly, limit sugary beverages to 1 -2 times per week, eat out 1 - 2 times per week)
Good (i.e., eat mostly whole foods, rarely eat processed foods, eat several servings of fresh fruits and vegetables daily, focus on organic, grass fed and non-GMO, rarely eat out, never drink sugary beverages)
Other  
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  • 500 characters left.
Required 5.
The support group is run through Facebook and the My Challenge Tracker App, both are private.  Do you have a Facebook account?
Yes
No
  • Comment:

  • 500 characters left.
Required 6.
What is the best way to reach you to discuss your responses?
email
Phone
Text
Other  
  • Comment:

  • 500 characters left.