• Getting To Know You

  • Contact Info

  • Birth Date
     - -
    2 digit month, 2 digit day, 4 digit year
  •  -

  • Current Measurements

  • Have you taken a before picture?
  • Are you currently pregnant or nursing?

  • Health Evaluation

  • DO YOU HAVE NOW, OR HAVE YOU IN THE PAST (check all that apply):
  • DO YOU EXPERIENCE ANY OF THESE SYMPTOMS (check all that apply):

  • Exercise & Diet History

  • Would you characterize yourself by always trying a new diet or weight loss program?

  • Personal Goals

  • Do you have a weekly weigh in day?

  • Coaching Information

  • Personal Support

  • Do you feel your family and friends support your decision to improve your health?
  • How would you prefer to connect with your coach? (Please indicate your preference.)
  • How often would you prefer to connect with your coach?
  • Are you available daytime between:
  • Prepping is a key component to being successful. Are you willing to prep?
  • Have you read the plan book?
  • Do you listen to the weekly THM podcast?
  • Are you a subscriber of the THM membership site?
  • Subscribing to the Membership Site is not mandatory, but if you’d like a shopping list with your weekly menus, it is. If you choose to subscribe you can save $10 off any subscription with code RY1340

  • WHICH TYPE OF MAMA DO YOU RELATE TO?

  • Check the one(s) that BEST describes you:
  • Should be Empty: