Goals Questionnaire

Name*

First Last

Email*

Phone*

Who is the Customer or Coach that referred you?*

What time zone do you live in?

PST - Pacific
CST - Central
EST - Eastern
ASK - Alaska
HST - Hawaii
MST - Mountain

How old are you?

What is your date of birth?

What is your current weight?

How tall are you?

Please Select One

Goals I would like to focus most on are:

Check all that apply to you:

We have designated Lead Coaches to help provide the best support and accountability. If you are not sure please select "I don't know, please match me."*

Is there anything else important for us to know?

Our commitment is to serve you best. Please share anything else you feel is important for us to know about your goals.

COMMITMENT STATEMENT (Please Read) I am committed to taking my health and wellness to the next level. I understand that a healthy lifestyle is not a diet, all or nothing, or about perfection. A healthy lifestyle is choosing to learn how to make positive changes with consistency and giving myself grace and patience for my body to change inside out. No matter my past ups and downs, I trust and believe that a community of encouragement and education on nutrition is my road to looking and feeling the way I deserve and desire. I am open to coaching, accountability and creating better habits. For my body to be strong I know my mind must also be strong to lead me there. I commit to fueling my mind with positive affirmations just as much as I will fuel my body with the right nutrition. I commit to fueling my body with a recommended nutritional regimen based on my personal goals, health, activity level & within my budget. My body is my temple and is the most important asset that I own. I may slip, I may even fall, but I CANNOT FAIL because failure is controlled by my actions and my reactions. I choose to fail forward not backward. Each speed bump I will learn from and keep moving forward.

18+ years of age or with the permission of a parent or legal guardian.
All customers use a nutritional regimen recommended by a Team Evolve Coach.
Meal Plans are purchased separately.
Your promise to intentionally seek a positive environment and positive people especially when you have a tough day or week. It is up to you to reach out so that our coach's know you need support to tackle a speed bump, make adjustments or get back on track.
Be a team player. We will go further together! We don't realize sometimes the effect of a positive word spoken to another. We encourage you to engage. Share a win you experienced or a struggle you overcame. Connect with intention and it will enhance your success and others.
A promise not to post or say things that may affect other's results in a negative way. Agreement to seek advice and support in a way that is looking for solution and resolution, not to complain or put down.
HAVE FUN!

Are you ready to commit?*

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