Jillian Michaels
Hey — I’m psyched that you’re here!
I just need to ask you a few personal questions before we get started. The more
honest you are, the more effective my advice will be.
1) What do you want from my program?  

2) How often do you exercise now?  


3) I know exercising is not easy. But which cardio activities do you enjoy (or at least don't hate)? (Check all that apply.)



4) Which body type most closely matches yours?  





5) Which type of foods do you crave? (Sugar is not listed, because we all crave it when we're tired and run down!)  

6) Are you an "emotional eater?" 

7) Do you have any of the following injuries? (Check all that apply.)




8) Are you concerned about any of these health conditions?
(Check all that apply.)








9) Please confirm your details...
Height: ft  in  
Your Age:    
Weight:     Gender:  
Goal Weight:      
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