Amped Lifestyle

Take the next 30 seconds to answer these few questions!

These questions, will allow me to understand more about you and how I can be of most help!

I'm excited to connect with you!

What are your current circumstances looking like right now? *

I feel completely unmotivated and I have no idea where to start

I am a full-time stay at home mom, feel overwhelmed to get healthier and create a greener environment

I currently run my own business, my stress is high and have little time to exercise

I’ve been working on a healthier lifestyle and need to be pushed/motivated for more

What benefits are you seeking most by starting a wellness program? *

Being able to take control of my most valuable asset, my health, so I can be a better example for those around me

I was an athlete in school and want to regain strength and feel better

Having someone work with me to do things correctly

Regaining a sense of strength and mindset as I create a healthier lifestyle, physically and environmentally

What point are you at in your journey of a healthy lifestyle? *

Never really had to watch what I ate, I don’t know where to start

My eating is out of control, regardless what I do there is no change

I don’t sleep well, hungry all day or go all day without eating, deal with a lot of inflammation

I’ve been incorporating a toxic free lifestyle and looking for more options

Where do you see yourself in the next 6 months? *

Reaching a weight goal that I haven’t seen in years

Regaining balance, strength and better eating program

Managing stress, time, and healthier lifestyle easier

Taking massive action to gain growth and register for my next challenge (race, triathlon, tough mudder, spartan, crossfit games)

What’s the biggest thing that is holding you back from starting an exercise program (in person or online)? *

Nothing anymore, I’m ready to pull the trigger and work with someone that will help me gain the results I desire in my current season in life

Lack of funds, some programs have been so expensive with little to no results

I don’t know where to start and I’m uncomfortable going to the gym

Lack of time to dedicate to just myself

Lack of guidance or knowledge of what would be best for me

Which applies to you most at the moment? *

The struggle with the weight changes I have had over the past years

Looking to streamline time, money and incorporate a healthier lifestyle for me and my family

I am completely stressed out and not sleeping, trouble getting through the day

I want to be stronger (mentally and physically)

Social medial Handle (FB, IG, LinkeIn)

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Phone *

First Name *

Last Name *

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All of your answers are confidential, they will not be shared with anyone!