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MMP Application

Complete this brief 10 question application to see if you are a good fit for the MMP. If approved you'll be directed to my booking page where you can select the best day and time for your free 30 minute consult.

Click the button below to start.

Start

Question 1 of 10

Are you currently a midlife adult age 30-60 looking to reclaim your health, rebuild your body and get back to looking & feeling your best again? (If NO - Stop here and close this window)

A

YES

B

NO

Question 2 of 10

What are your top health and fitness goals?

(Select all that apply)
A

I want to lose 15-20lbs (or more) over the next 12 weeks

B

I want to learn how to eat healthier for my body, goals and stage of life.

C

I want to build muscle, get stronger and look my best again.

D

I want to build better health habits and get results that last long term.

E

All of the above

F

None of the above

Question 3 of 10

What area/s do you struggle with the most and need the most help with?

(Select all that apply)
A

Nutrition

B

Exercise

C

Lifestyle & Health Habits

D

Mindset & Motivation

E

Accountability

Question 4 of 10

What have you tried in the past to help you reach your goals?

Question 5 of 10

When are you looking to get started on a new workout program and nutrition plan to help you with your health and fitness goals?

A

As soon as possible

B

1-2 weeks

C

2-3 months

Question 6 of 10

What is your full name? (First & last please)

Question 7 of 10

What is your primary e-mail? (call booking details will be sent here)

Question 8 of 10

What is your cell phone number? (call booking details will be sent here)

Question 9 of 10

On a scale of 1-5 (5 being the greatest) how serious and committed are you to making changes and achieving your goals?

A

1 (Not at all)

B

2 (Meh!)

C

3 (Somewhat)

D

4 (I'm 80% committed)

E

5 (I'm 100% all in & ready to do this!)

Question 10 of 10

As you may already know, I have a coaching program called the Midlife Makeover Program (MMP). This program is designed specifically for men and women 30-60+ who want to lose body fat, build muscle and get their body back to looking and feeling their best again in 12 weeks or less. 

 

If during our call we both agree you are a good fit for this program. What funds can you invest towards us working together to help ensure you achieve your goals?

 

(This program is not a cheap gym membership you never use, quick-fix diet that trashes your metabolism or a cookie cutter meal plan/workout routine that doesn't work...  The MMP is a high-level coaching & accountability program built exclusively for men & women age 30-60 who are 100% ready to do the work and change).

A

Less than $500

B

$500 - $1,000

C

$1,000 - $1,500

D

$1,500 - $2,000

E

$2,000 - $3,000

Confirm and Submit