Weight Control

Weight Loss Survey

Hello from Norma Maldonado

If you are thinking about losing weight, trying to lose weight, in the process of losing weight, or struggling to lose weight — please take this short survey. You will be helping me

to have a clear picture how to assist you to solve your concerns

. In fact, the results are totally anonymous.  And if any questions make you uncomfortable — just skip them!

Thank you in advance! You all are my heroes!

    Are you male or female?

    MaleFamale

    What is your age?

    17 or younger18-2021-2930-3940-4950-5960 or older

    Where did you hear about me?

    FacebookBlogPodcastInstagramGoogleOther

    What are your six biggest life and health goals?

    Improved healthFeel more attractivePlease others (family, friends, spouse)Have more confidenceFit into my favorite clothesEase joint painOther (please specify)

    If you are 100% honest, what do you believe has prevented you from reaching your full potential?*

    Have you worked with a coach before or invested in your personal development in the past? What was the experience like ?

    Why do you believe you are a good fit for working with Norma (me) and way is the time to star?

    What do you expect from working with Norma (me)?

    Are you ready to get going and make some changes in your life?

    Yes, I'm ready to start today!Yes, I'm ready to start within the next couple of weeks.I'm not ready to start making changes yet, but I am thinking about it,

    Are you willing to invest in a coach and suplements to make changes in your health?

    I have finances available to invest in myself and creating a healthy body, healthy mind and a happy heart.I am willing to find the finances to invest in myself and creating a healthy body, healthy mind and a happy heart.I am not willing to invest financially in myself currently.

    Is there anything at the moment that would stop you pursuing your goals?

    What is your availability and flexibility for coaching calls

    MondayTuesdayWednesdayThursdayFridaySaturdaySunday

    First Name *

    Last Name *

    Email *

    Best Contact Number *

    I am happy to added to Norma's email list which means I will receive news, information, inspiration and some marketing emails.

    YesNo

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