I'M READY TO CHANGE MY LIFE

I'M READY TO CHANGE MY LIFE
If you're ready to be happier, healthier, lose weight, reduce stress/anxiety and have more energy and balance in your life, this group is for you! For 30 days, we will be focusing on not only clean eating & exercise, but we'll also be reading the book 'The Miracle Morning' - a book that has COMPLETELY changed my life. It will help you to become a morning person and start your day with meditation/prayer, gratitude, positive affirmations, goal setting & visualization, exercise & more... all before 8am.
Name *

First Name Last Name
Email *
example@example.com

SOCIAL MEDIA

FACEBOOK (ex: facebook.com/JaclynStokesFitness)
INSTAGRAM (ex: @jaclynstokes)

	Country

WHERE DO YOU LIVE?

US CANADA UK
DO YOU HAVE A COACH?

NO YES, JACLYN IS MY COACH! YES, I HAVE ANOTHER COACH. I DID, BUT I'M NO LONGER WORKING WITH THEM.
WHAT ARE YOUR GOALS? (check all that apply)

TO LOSE WEIGHT/BE FIT TO EAT HEALTHIER TO BE A MORNING PERSON TO REDUCE STRESS/ANXIETY TO HAVE MORE ENERGY & FOCUS TO MEDITATE DAILY
WHAT ARE YOUR BIGGEST STRUGGLES?
HAVE YOU EVER TRIED A BEACHBODY HOME WORKOUT PROGRAM BEFORE?

YES NO
HAVE YOU EVER TRIED SHAKEOLOGY BEFORE?

YES NO
WHY ARE YOU INSPIRED TO CHANGE YOUR LIFE?
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