21 Day Summer De-Bloat Exit Survey

21 Day Challenge Exit Survey

Congratulations! You have done exceedingly well if you have made it to this point! Complete the survey so we can celebrate your success together!

*Must fully complete this survey to be eligible for the $500 Cash Prize

Name

Weight (lbs.)

Weight When You Started the Challenge (lbs.)

Height (ft'in")

What Was Your Biggest Win From The Challenge?

What are You Most Proud of Yourself for Since Beginning this Challenge?

What was Your Primary Goal when Starting the Challenge?

Have you Made Progress Toward that Goal During the Challenge?

*If Other, Please Explain

What was Your Biggest Struggle?

What goals do you want to work on next, or continue to work on?

How Would You Rate Your Adherence to the Challenge

Are You Currently a 1:1 Client?

Please Upload Final Progress Photos Here! (Front,Side, Back)