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What is Your Goal?
Lose WeightGet HealthyBoth
What is your height and weight?

What is your ideal weight that you want to reach?

How Soon Would You Like To Begin Losing Weight
I would like to start ASAPWithin the next monthI am not going to start any time soon

When was the Last Time you were at your Ideal Weight?
Less than a year1-3 Years3-5 YearsOver 5 years

Biological sex and hormones impact how our bodies metabolize food.
What is your biological sex?
MaleFemale

What is your age?
20s30s40s50s60s70+

Having something to look forward to can be a big motivator to stick to your plan.
Do you have an important event coming up?
VacationWeddingHolidaySummerReunionBirthdayOther or none

All people need a slightly different strategy depending on their current lifestyle.
Which best describes you?
My diet and activity need a lot of workI have some healthy habitsI mostly eat well and stay active

What is your main reason for wanting to lose weight? (Please choose what is most important)
Improve physical appearanceEngage more with familyBecome healthierFeel better dat-to-dayOther

Which of the below best describes your current priorities?
I am only focused on losing weightI'd like to gain some muscle while I lose fatGaining muscle is more important to me than losing fat

Do you have any significant back issues?

YesNo

Are you at risk of any of the following?
Testosterone deficiencyHeadachesNeck, back and joint painDigestive challengesFatigue (low energy levels)InsomniaHeart Disease of StrokeHigh Blood PressureDiabetesOsteoarthritisDepression or AnxietyOtherNone

Have you ever been diagnosed with or received treatment for diabetes?
YesNo

How Physically Active are you?
Frequently activeOccasionally activeLimited Activity

Did you play sports or follow any other structured activity routine growing up?
YesNo

Which best describes the area you live in?
The countryThe suburbsA major city

What is your Diet Like?
Only healthy mealsTry to eat healthy when I canI don't pay attention to my diet

Weight Loss Methods You Have Tried (check all that Apply
Prepared mealsShakesFad dietsSurgery, hormone therapyDiet pillsExerciseNever tried before

What is your experience losing weight?
It worked but the weight came backI tried but gave upA previous program was too demandingI felt hungry or weakI lost weight but the method was unhealthyI have had success but am open to trying a new systemNo experience

How Serious are you about Losing Weight?
Very seriousFairly seriousNot serious

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