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Weight Loss for Go-Getters
Post-Program Questionnaire
First and Last Name
Email
On a scale of 1-10, how well do you sleep (1 being I don't sleep much at all, 10 being great I can fall asleep anywhere, anytime)?
Do you wake up during the night?
Yes
No
What time do you usually go to bed and how do you feel when you wake up?
On a scale of 1-10, how sharp is your mental clarity (1 being not sharp, 10 being razor sharp)?
How much water do you drink per day?
How do you feel after meals?
How much money are you spending a week on food? (That includes take out, dining out, groceries, etc. per week):
How much weight/how many inches have you lost on this program?
What are your three biggest wins from working together? What changed in your life?
Anything else you want me to know about your transformation?
What surprised you the most about our time working together?
What would you tell a friend who's considering WLFGG?
If you could change anything about the program, what would it be? Was there anything that just didnā€™t work?
Are you open to providing a testimonial?
Yes
No
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