Do you have children? Yes No

How did you hear about us?

Would you say you were a?

How would you describe the condition you are in now?

Which of the following are important for you at the moment?

How important is it to achieve these results?

How long have you been thinking about this?

Do your family and friends support you in making this decision?

When would you ideally like to see your results by?

Is there any other reason why you can't get started virtually straight away?