Your Start


	WELCOME! I am Sabrina, your PERSONAL WELNESS COACH ! Is this your goal?: dream shape, fitness, more energy and a better health? Let's be a good team and let's GO FOR IT! You'll receive my personal assistance according to your own, individual needs! Of course, this is FOR FREE at any time! I will keep everything VERY SIMPLE for you.

All you need now is:




	5 minutes



	a balance




	a tape measure

Are you ready?


	So let's start with some easy steps on your way to achieve your goals, FOR YOUR HEALTH AND YOUR HAPPINESS Please fill in this form. Your answers should be EXACT and HONEST. This is VERY IMPORTANT for me, because I will commit myself to make sure you will achieve a perfect RESULT! Of course it will only work, if YOU will commit yourself, too!

Name :

Surname :

Address :

City :

Country :

Telephone :

Best time to contact :

eMail :

Skype ID :

Date of birth :

Height :

Weight :

Children :

Profession:

Weight Problems since :

Why? :

Eating Habits:

Breakfast :

Lunch :

Dinner :

Snacks :

Beverages :

Diseases :

Medication :

Former Diets :

Sport :

Ideal Weight :

Personal Goal :

(i.e. any favourite dress you want to fit in etc.)

Body measures :

I am interested in:

weight control

sports nutrition

A :

becoming an affiliate*

B :

*Affiliates have lots of advantages, like:
reduced prices, access to special websites, etc

C :

earning money

D :

E :

Comments :

F :

G :

H :