Healthy & Fit for the Holidays: Fitness, Nutrition and Health Coaching Program with Heather Glenn

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Please complete the interest form below, including your program preferences, to learn more about the "Healthy & Fit for the Holidays" program. Once you've completed the form, I'll email you with additional info and next steps!

I'm excited that you are considering the opportunity to work together in November & December to help you keep healthy, fit and energized during the holidays!

Looking forward to helping you make fitness and a healthy lifestyle simple and sensible so you can thrive this holidays season!

First Name *

Last Name *

Email Address *

Best Phone Number *

What are your current health and fitness goals? *

Which do you struggle with most when it comes to your fitness? *

Finding time

Knowing what to do

It's not fun

Dealing with an injury

Access to a gym, classes or equipment is an issue

Convenience

Staying consistent / losing motivation

Other:

Required

Which do you struggle with most when it comes to your nutrition? *

Skipping meals

Portion sizes

Knowing which foods are healthy

Meal ideas

Preparing healthy food options

Eating healthy while traveling or out at work/social events

Getting in enough nutrients

Knowing what my plate should look like

Emotional eating

Cravings

Finding time to shop

Knowing what to buy at the store

Finding time to cook

I feel like I need a clean break from poor eating habits

I like the idea of doing a cleanse or detox program to flush my body and reset my internal systems

Other:

Required

Where else do you struggle when it comes to living a healthy lifestyle? *

How did you hear about this program? *

Facebook

Instagram

Friend

I'm a Current Client

Other:

For my fitness, I'm interested in... *

A 3-month online fitness membership where I have access to over 1000 quick, video workouts I can do anywhere in minimal time to keep me fit through the holiday season

A 12-month online fitness membership ($20 more) where I have access to over 1000 quick, video workouts I can do anywhere in minimal time that will keep me fit through the holidays and make 2019 my healthiest year yet!

Not sure

Required

For my nutrition, I'm most interested in a program that... *

Is structured and contains specific portion guidelines using containers to keep portions in check. I like having a little flexibility with the foods I eat but also want some structured guidelines and external tools to help keep me in check. I like the idea of being able to track what I eat in an App.

Is more flexible with general behavioral guidelines using volume eating and the eye-ball method. I like the idea of focusing on what I can eat vs. what I can't and tracking my eating behaviors in a journal. I want to learn more about how to fill my plate, grocery shop and eat while traveling, attending social events and eating out.

Not sure

Required

I am considering the 3-Day Refresh Cleanse as an option to reboot and drop a few pounds after Thanksgiving weekend ($40 upgrade) *

Yes

Not sure, need more info

I am interested in learning more about fitness supplements to support my workouts (check all that apply)

Pre-Workout to give me energy to push through my workouts and perform at my best (no artificial flavors or stimulants)

During workout hydration to replenish electrolytes and keep proper vitamin and mineral balance (like Gatorade but without all of that sugar)

Post-Workout branched-chain amino acid protein shake to help replenish your muscles with protein and amino acids so your body can repair and build muscle. (Yes, as women, we need these building blocks too!)

Not sure

No Thanks

I'd like to complete my registration and purchase by Friday, Oct 26th to receive my early bird Amazon gift card ($10-$15 depending on package purchased)

Yes

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