Look and Feel Trim and Trimendous with Energy and Weight Formula
Date:______________________________
Name:_____________________________
Mailing Address:____________________ _____________________
Phone-Work:________________________ Home:___________________________
Fax:_______________________________
E-Mail:_____________________________
Best time to call:_____________________
1) On a scale of 1 to 10 ( 10 being very serious ), how interested are you in:
Losing weight?________________
Gaining energy?_______________
2)What are your weight loss goals?
Pounds to lose?_________________
Desired sizes? Women-Dress size?___________
Jean size?______________
Men- Waist size?_____________
3)What other weight loss programs have you tried?
4) Why do you think they failed you?
5) How would your life be different if you met your weight loss goals?
6) Did you have a weight loss personal coach?
Would you use one if it came with the program Free?
7) If you found that this product worked well for you, would you be willing to share it with those you know who may also want to lose weight or increase their energy? ________________________________________________________________
