Knock out all your 2013 goals!

Ready for 2013? its 12 days away!!! Want to take your athletic performance to the next level? Build muscle, drop weight, fuel healthier, more energy? Let me know!

Fill out the survey below and send it to DerbyAmerica@gmail.com for a free nutrition analysis and suggestions on how to take your game to the next level.

Name:
EMail:
Phone:
Health/Performance Goals:
Height:
Weight:
Avg hours of sleep per night:

What time do you usually wake up?
Do you eat breakfast?
If yes, what and what time?

AM Snack?
If yes what and what time?

Lunch?
If yes what and what time?

PM snack?
If yes, what and what time?

Dinner?
If yes what and what time?

Water: how much per day usually?
what else do you drink? (coffee, soda, energy drinks, etc)

Do you take and Supplements?
If no, are you open to taking any?
If yes, what do u take?

Outline your weekly Workouts/Practices:

How is your energy on a scale of 1-10? (1=i need a nap, 10= wheeeee I am awesome all day!)

How much $ do you spend per day, week, or month on average eating out or on senseless junk? đŸ™‚

Scale of 1-10 how ready are you to kick your goals in the FACE?

Whimsey
After an 8 week challenge, my client Whimsey Kill, was able to drastically change her health and body! You can too!

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