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Free Personality Diet Assessment

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Neurotype Challenge Survey and Metabolic Assessment

*must fully complete this survey to be eligible for the $1,000 cash prize

After you hit submit you will be promoted to register for our challenge wrap up call and winner announcement.

"*" indicates required fields

Step 1 of 3

33%

Name*

First Last

Email*

Phone*

Height*

Current Weight*

Approx weight when you started the challenge?*

Goal Review Section

What was your biggest win from the challenge:*

What are you most proud of from the challenge?*

What was your primary goal when starting the challenge?*

Weight Loss (more than 20 pounds to lose)

Performance (optimize my performance for a sport)

Build Muscle (build lean tissue to improve body composition and strength)

Health/Longevity (I want to live my life the best way possible. I want to feel my best!)

Aesthetics (I just want to look good naked! I have an event coming up I want to prepare for)

Other

Have you made progress toward that goal during your time in the challenge?*

I reached my goal!

I have made progress and am looking to make additional progress

I have not made progress but I've developed important and sustainable habits

Other

What was your biggest struggle:*

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

Metabolic Assessment

How many calories on average are you eating per day?(if not tracking, provide a rough estimate)*

How would you rate your food quality?*

How would you rate your protein intake?*

Do you find yourself consuming large amounts of coffee or energy drinks to get through the day?*

How would you rate your daily energy levels?*

Do you find that you are able to cope with and manage your day to day stress?*

How do you cope with day to day stress (ex. walks alone, meditation, reading, watching TV)?

On average, how many hours of sleep do you get each night?*

6 or less hours

7 or less hours of sleep per night

7-9 hours of sleep per night

Other

How would you rate the quality of your sleep?*

How would you rate your daily stress levels?*

Do you have a sleep routine (I.e. go to bed and wake up at generally the same time each day)*

How active are you?*

Very sedentary (no exercise routine/desk job)

Sedentary (no exercise routine/minimally active during the day)

Moderately active (exercise 1-2 days per week/about 5k steps a day)

Active (consistent exercise 2-3 days per week/active throughout the day)

Highly active (physically demanding job/consistent exercise or consistent exercise 4-5 days per week and 8-10k steps/day)

Other

What is one thing you would improve for the next challenge:*

Are you currently a 1:1 client?*

Please upload before/after images here.

Drop files here or

Accepted file types: jpg, png, Max. file size: 1,000 MB.

After you hit submit you will be promoted to register for our challenge wrap-up call and winner announcement.

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