(W)holistic Health Boss Interest Survey 2016

This is 100% CONFIDENTIAL. Your privacy is important.

I want to know how I can support you more so that you can have a deeper understanding of what's going on with your health to really fix the issues once and for all, take back control and get back to feeling like yourself again. In Health ~ Jenn Malecha

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* 1. What health and fitness challenges keep you from achieving your ideal health and weight? (select all that apply)

Whacky Hormones- PMS, low libido, thyroid issues, etc.

Poor Immune System- get sick frequently, allergies, infections etc.

Disturbed Digestion- upset stomach, irregular bowel movements, acid reflux etc.

Sleep- hard to fall asleep, wake up frequently, just don't feel rested, etc.

Exercise- don't know what to do, lack motivation, no time etc.

Weight & Performance Plateaus- just feel stuck, tried everything and nothing works etc.

Diet- sticking to a plan, don't know what's right for me, cravings etc.

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* 2. What would you like to see more of in the weekly email/videos/blog? (select all that apply)

Healthy Eating Advice

Workout Tips

Cutting Edge Health Info

More Meditation, Mindfulness and Mindset Tools

Essential Supplements

Insights on Adrenals, Thyroid and Hormones

Maintaining and Losing Weight

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* 3. What do you also enjoy hearing about (select all that apply)...

Holistic Health Practices

Personal Training

Personal Health Coaching

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* 4. Which types of events, offerings and programs peak your interest? (select all that apply)

Cleanse Challenges

Live Webinars and/or Virtual Discussion Groups

Health & Fitness Retreats

Group Health Re-building/Improvement Programs

Fitness Challenges

Health Challenges

Online Workshops

1-on-1 Health Coaching

1-on-1 Personal Training

Private Facebook Page to connect with other health-minded people, share information and get guidance

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* 5. Where do you hangout on social media the most? (select all that apply)

Facebook

Instagram

Twitter

Periscope

Snapchat

Other (please specify)

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* 6. Are you male or female?

Female

Male

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* 7. What is your age?

20 or younger

21-29

30-39

40-49

50-59

60 or older

(W)holistic Health Boss Interest Survey 2016

This is 100% CONFIDENTIAL. Your privacy is important.

Question Title

* 1. What health and fitness challenges keep you from achieving your ideal health and weight? (select all that apply)

Question Title

* 2. What would you like to see more of in the weekly email/videos/blog? (select all that apply)

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* 3. What do you also enjoy hearing about (select all that apply)...

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* 4. Which types of events, offerings and programs peak your interest? (select all that apply)

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* 5. Where do you hangout on social media the most? (select all that apply)

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* 6. Are you male or female?

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* 7. What is your age?

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* 8. Feel free to leave any other comments. All feedback is appreciated!

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* 9. Enter your full name and email address to be entered to win 3 FREE health coaching or personal training sessions with me!