12 Day Power Detox Program Survey

Name*

PrefixFirst NameLast Name

Email Address:*

* Pls use email address you check often

Location*

Street Address

Street Address Line 2

CityState / Province

Country

When did you finish the detox program?*

Date

Specify the number of days completed *

What were your favorite smoothies/days? Check all that applies.*

Which goals/improvements did you achieve during the 12 Day Power Detox Program ?*

How much weight did you lose in pounds? Include other measurement i.e inches around waist or hips if available.*

When did you feel energized the most during the 12 Day Power Detox Program ?*

In the morningAfter lunchAll day longOther

Did you notice any improvement in your sleep? How many hours of sleep did you get at night during the 12 Day Power Detox Program ?*

Less than 4 hours4 to 6 hours7 hours or moreOther

What habits, cravings, addictions were you able to stop? It may be food or other things.*

What new habit(s) or new thing(s) did you discovered during the detox?*

In a few words, please tell us how the devotional helped you improve your emotional well-being.*

What were your favorite snacks?*

How often did you exercise in a week?*

less than 1 hour1 - 2 hours3 or more hours

Did you drink the detox tea or any of the other teas suggested i.e Green Tea, Ginger Tea or Peppermint Tea. ?*

YesNoOther

Did you drink 64 ounces (4 bottles) of water or liquid daily?*

YesNoOther

Did you do the Salt Water Cleanse? Pls share your experience.*

Would you do the 12 Day Power Detox Program again in the future?*

YesNoOther

Would you recommend the 12 Day Power Detox Program to your family and friends?*

YesNoOther

Do you give It's Time Fitness permission to share your success story on our website and social media?*

YesNo

Success Story/Testimonial: Please use this space to share your overall experience i.e observations, challenges, feedback, advice, recommendations, results etc. How did you feel Spirit, Soul and Body after the detox program? This will be included in the next edition of the 12 Day Power Detox Program. Only Title, Location, First Name and First letter of last name will be used for privacy reasons.*

Thank you so much for sharing your success story/testimonial for the 12 Day Power Detox Program. We're looking forward to hearing your life changing results and success story.

If you need additional help in achieving your health and fitness goals, please consider working with Health & Fitness Coach Ade via one of her online programs.

Visit www.itstimefitnessaz.com/discovery-session to schedule a Complimentary Discovery Session.

Ade is looking forward to working with you to achieve your health and fitness goals. If you have any questions, please feel free to contact her via email at ade@itstimefitnessaz.com