1. Do you have a weight loss goal in mind?
(At least one answer must be selected)

2. How quickly do you want to reach your goal?
(At least one answer must be selected)

3. Who will be supporting your weight loss efforts?
(At least one answer must be selected)

4. Next, tell us about your experience with weight loss.
(Check all that apply)

5. Tell us about your exercise and physical fitness. Check what best describes you in the past 30 days:
(At least one answer must be selected)

6. Let's uncover the reasons behind your body's resistance to losing weight!
(Check all that apply to you)