Anne Miller - Start

Email address *

Name *

Age *

Gender *

What is your #1 struggle when it comes to nutrition? *

What is your #1 struggle when it comes to exercise? *

What is your current activity level? (How many steps per day? Do you current work out? ) *

What are your current goals? *

How committed to your goals are you on a scale of 1-10? *

	1	2	3	4	5	6	7	8	9	10
Not at all											I'm ready to do whatever it takes!

What would need to happen over the next 6 weeks for you to feel like our time together was a success? *

Current weight *

bust measurement *

waist measurement *

hip measurement *

right thigh *

left thigh *

6 Week Summer Coaching Package *

Please follow the link below for payment.

$197.00 total price

Please put "summer coaching package" in the description so I can easily find your payment

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