Mind and Body Questionnaire How old are you? :*Your current weight:* Your Gender:*FemaleMaleWhere did you hear about us? :Friend / existing clientFacebookBlogInstagramWebinarOther (use box below)Other: How many times a week do you do each of the following? :Lift Weights: Endurance: Team Sports: Yoga/Pilates: CrossFit Classes/Bootcamp Classes/Body Pump: Other activity: How long have you been at your current weight? How much weight do you want to lose?* Why have you decided to make changes now? How do you feel in your current situation?*Why do you think you have failed in the past? :*Is there anything at the moment that would stop you pursuing your health, fitness and weight loss goals at present? :What is the number one goal you would like to achieve in the next 6 months? What will achieving this goal do for you physically, mentally and emotionally? :*Out of 10, what is your present level of commitment to address your health and reach these goals that relate to your health, weight and lifestyle? (10 being 100% committed) Do you have the finances available to commit to a mentoring program?*I have finances available to invest in my personal growth, health, fitness and weight loss.I am willing to find the finances available to invest in my personal growth, health, fitness and weight loss if I believe the program can deliver the results.I am not willing to invest financially in my personal growth, health, fitness and weight loss at this time.Name:* First Last E-mail:*Best contact number:* Submit formReset BMR Calculator You use energy no matter what you’re doing, even when sleeping. The simple calculator below will calculate your Basal Metabolic Rate (BMR) – the number of calories you’d burn if you did nothing and stayed in bed all day.