You can always press Enter⏎ to continue
Welcome!
Please complete and submit this form
START
1
What's your name?
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
What's the best email to contact you?
*
This field is required.
example@example.com
Previous
Next
Submit
Press
Enter
3
What's the best phone number to reach you?
*
This field is required.
Use country code 1 for US and Canada
Country Code
Area Code
Phone Number
Previous
Next
Submit
Press
Enter
4
What is your age?
*
This field is required.
Previous
Next
Submit
Press
Enter
5
Are you interested in working with a specific Scooby Health coach?
*
This field is required.
Please Select
Not sure, please choose for me
Jason Theobald
Alyssa Cooke
Chandra Krause
Crystal Stretch
E Ramey
Jamie Askey
Jane Karlson
Kayla Forcier
Larry Wilson
Meghan Santa Barbara
Natasha Hopkins
Sammy Houle
Please Select
Please Select
Not sure, please choose for me
Jason Theobald
Alyssa Cooke
Chandra Krause
Crystal Stretch
E Ramey
Jamie Askey
Jane Karlson
Kayla Forcier
Larry Wilson
Meghan Santa Barbara
Natasha Hopkins
Sammy Houle
Previous
Next
Submit
Press
Enter
6
Please indicate if you are following any Scooby Health coaches listed below on Instagram:
*
This field is required.
Jason - @jasontheobald_scoobyhealth
Alyssa - @alyssamcooke_scoobyhealth
Chandra - @coachc_scoobyhealth
Crystal - @coachcrystal_scoobyhealth
E - @eramey_scoobyhealth
Jamie - @fit.nurse.etx_scoobyhealth
Jane - @trainlikejane_scoobyhealth
Kayla - @kayla_scoobyhealth
Larry - @liftingwith.larry_scoobyhealth
Meghan - @dr.meg_scoobyhealth
Natasha - @natasha_scoobyhealth
Sammy - @sammy_scoobyhealth and @coachsammy_scoobyhealth
Scooby Health - @ scooby_health
I am not currently following any Scooby Health coaches on Instagram
I am not on Instagram
Previous
Next
Submit
Press
Enter
7
Please indicate if you are following any Scooby Health coaches listed below on Instagram:
*
This field is required.
Jason - @jasontheobald_scoobyhealth
Alyssa - @alyssamcooke_scoobyhealth
Chandra - @coachc_scoobyhealth
Crystal - @coachcrystal_scoobyhealth
E - @eramey_scoobyhealth
Jamie - @fit.nurse.etx_scoobyhealth
Jane - @trainlikejane_scoobyhealth
Kayla - @kayla_scoobyhealth
Larry - @liftingwith.larry_scoobyhealth
Meghan - @dr.meg_scoobyhealth
Natasha - @natasha_scoobyhealth
Sammy - @sammy_scoobyhealth and @coachsammy_scoobyhealth
Scooby Health - @ scooby_health
I am not currently following any Scooby Health coaches on Instagram
I am not on Instagram
Previous
Next
Submit
Press
Enter
8
What's your current activity level?
*
This field is required.
None. I spend most of my day sitting (less than 5000 steps per day)
I am active 3-5 days a week and spend a large part of my day on my feet (less than 10,000 steps per day)
I am very active 6-7 days a week and have a physically demanding job (greater than 10,000 steps per day)
Previous
Next
Submit
Press
Enter
9
What is your weight training experience?
*
This field is required.
I have no experience weight training
I have been weight training less than 2 years
I have been weight training greater than 2 years
I have been weight training greater than 5 years
Previous
Next
Submit
Press
Enter
10
How often do you currently weight train?
*
This field is required.
I do not weight train
I weight train 1-2 times per week
I weight train 3-5 times per week
I weight train 6-7 times per week
Previous
Next
Submit
Press
Enter
11
What are your current diet/nutrition habits?
*
This field is required.
Very poor! Help!
Some good days, some bad days - very inconsistent
I eat "healthy" but lack the knowledge or motivation to reach my goals
Great! I track macros and follow a consistent meal plan
Previous
Next
Submit
Press
Enter
12
Which category of coaching are you interested in?
*
This field is required.
You can choose multiple categories, if needed
General Nutrition
Functional Nutrition
Competition Prep
Competition Off Season
Weight loss resistance
Previous
Next
Submit
Press
Enter
13
On a scale of 1-5, how dedicated are you to hiring a coach and sticking to it?
*
This field is required.
Choose 1, 2, 3, 4, 5
1 - is not very motivated, 5 - is incredibly motivated
Previous
Next
Submit
Press
Enter
14
Why are you interested in hiring a coach?
*
This field is required.
Previous
Next
Submit
Press
Enter
15
How did you hear about us?
ex: referred by friend, Instagram, FaceBook, our website, etc
Previous
Next
Submit
Press
Enter
16
If you have an Instagram handle, please add it here:
This is NOT a required question
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
16
See All
Go Back
Submit