5 WEEK TRANSFORMATION PROGRAM SELF ASSESSMENT & PROGRESS SURVEY

Please complete the following survey to provide your thoughts on how you feel about your progress thus far in the program.

Feel free to be as detailed as you would like in the open ended questions and answer all questions to the best of your ability. We look forward to your continued participation and progress in the program. Let's I.R.I.S.E.

Are you following the 5 Week Transformation Program? *

Yes
No
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Where do you need to improve? *

What are your 3 biggest barriers you feel you are facing? *

Have you consistently applied meditation and affirmations during your time in the program? *

Yes
No
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Have you followed the meal plan and recipes supplied in the portal? *

Yes
No
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Are you currently using any Isagenix Products? *

Yes
No
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Do you participate in the detox days or cleansing with coach? *

Yes
No
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Are you using any outside supplements or protein shakes? *

Yes
No
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How often do you eat out of the house? (such as wedding, party, family function etc.) *

More than 3 times a week

More than once a week

2 times in a month

1 time in a month

Less than 1 time in a month

How many days do you exercise in a week?

Daily

5 to 6 times a week

3 to 4 times a week

1 to 2 times a week

Never

How much time do you exercise for each session?

40+ Minutes

30-40 Minutes

20-30 Minutes

10-20 Minutes

Less than 10 Minutes

First Name *

Last Name *

Email *