COMMIT Customer Questionnaire

Hi, It's Bob and Jenny and We are SO excited to help you get the body and energy you are looking for. Since you've made the step to COMMIT, we are making a step to COMMIT to you! We’re committed to giving you all the resources and encouragement you're going to need.

One way we do that is to have you be a part of our COMMIT COMMUNITY. This is a very private FaceBook group that is only for people who COMMIT. This is where you will get access to your BONUS material (4 nutrition courses and a new workout every week!) We will be in the community answering questions and holding Q&A sessions as well as giving you all sorts of helpful information. IT'S ALL ABOUT SETTING YOU UP FOR SUCCESS!

We know that you are a champion and that you have the crazy ability to do anything you set your mind to. We have 100% faith in this One/80 System and the faith in you.

In order to serve you best, we want to know more about you. Please fill out this form and we’ll see you on the other side!

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Area CodePhone Number

Date of Birth*

Date

What is your Facebook name? By adding your name here, you are giving us permission to add you to the community. *

I don’t have a Facebook account, please let me know my options.

I AGREE

Are you under the care of a physician for any medical conditions?*

YESNO

If yes, what health conditions or concerns do you currently have? Note: If yes, please ask us for supplement information to take to your doctor.

What do you currently use to boost your energy?*

SODACOFFEEENERGY DRINKSNOTHING

Rate your energy in the morning on a scale from 1-10 (10 being amazing)*

Rate your energy in the afternoon on a scale from 1-10 (10 being amazing)*

Rate your energy in the evening on a scale from 1-10 (10 being amazing)*

Rate your Caffeine or stimulant sensitivity on a scale of 1-10 (10 being extremely sensitive) *

I would like to:*

LOSE 10 LBSLOSE 20-30 LBSLOSE 50-100 LBSDECREASE BODY FAT AND INCREASE MUSCLE

Do you move waste daily?*

YESNO

What is the most difficult part of eating healthy?*

CRAVINGSMEAL PREPOVEREATINGDON’T EAT ALL DAY

Do you eat breakfast?*

YESNO

Do you eat 3 meals and 2 snacks daily?*

YESNO

When eating protein, do you prefer?*

What kind of Exercise do you like?*

We highly recommend that you upload a before picture! Please wear form fitting clothing, but no undergarments. Work out clothing, shorts, sport bras are all great choices. Take a front, side, and back FULL BODY picture. Upload pics below.

Browse Files

On a scale of 1-10 (10 being highest level) how committed are you to your health goal?*

In 10 words or less, what is the most compelling reason you are committing to your health goal?*

I would like to know more about getting a discount on my products*

YESMAYBENOI AM ALREADY GETTING A DISCOUNT

I would like to know more about earning income with AdvoCare*

YESMAYBENOI AM ALREADY EARNING INCOME WITH ADVOCARE

I understand that my AdvoCare Distributor does not provide medical advice and that I should go to my health professional for any and all health conditions or concerns. (check box)*

I AGREE TO THE ABOVE STATEMENT

I have friends who would like to lose weight, gain energy, or gain muscle. I would like to share this with them.*

YESMAYBE, IF I SEE RESULTSNO

Do you have any questions for us or comments that you feel are important for us to know? (less than 150 characters)