transformation

application

Name

First Name

Last Name

Phone

(###)

###

####

When you think about achieving a "total mind-body transformation", what does that mean to you?

What is your "why"? What will motivate you to fully commit to and complete this program? Be specific.

What is your age?

What is your current height?

What is your current weight?

At what point in your life did you feel the most comfortable in your body? What was your weight? What was your age? How long did this period last?

What efforts have you made in the past to lose weight and live a healthier lifestyle? Why do you believe these did not work?

How many days/week are you willing to exercise?

How many days/week are you willing to meditate?

On a scale of 1-10, how willing are you to commit to following a precise nutrition plan that will help you achieve your goals?

Are you willing to cook/prepare food at home for the vast majority of this program (90% of the time)?

Are you willing to eat 3 meals/day (not skip meals and not snack frequently)?

Yes

Please write down everything you have had to eat and drink in the last 24 hours. If this is not a "typical" day for you, please list specifically what you might eat on an average day.

Are you willing to take before and after pictures for promotional use by Evolve Nutrition and Yoga?

Yes

If you have social media, are you willing to post on your progress and tag @evolvenutritionyoga?

Yes

On average, how many hours do you sleep at night? Do you feel rested in the mornings? Describe any challenges you have with sleep.