Revisit Form – Program PersonalName *Date * HealthWhat overall positive changes in your health and well-being have you noticed since starting your health program? *What goals have been met? *What recommendations did you find helpful and which do you continue to use? *Are there areas you would like to focus on, shift, or approach differently in order to meet your goals? *Changes in weight? *How is your sleep? *How has your mood changed? *How is your digestion? Are you experiencing any bloat, gas, diarrhea or constapation? What is your healthy outlook? *About the sameBetter than before, making progressWay better than before, excited to learn moreWhat are you doing for exercise? *What is your main concern at this time? * FoodAre you cooking more? *YesNoWhat foods do you crave? *What is your diet for Breakfast these days? *What do you eat for lunch? *What do you eat for Dinner? *What do you snack on and drink? *How have your food choices been? On a scale of 1-10 what has been your dedication level to follow recommendations given? *Any questions about foods or ideas introduced so far? *What subjects do you think will help you gain more progress? *Anything else you would like to share? *Please list any people in your life you think could also benefit from work like this. *Email * VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank: There was an issue loading your exit LeadBox™. Please check plugin settings.