Get Acquainted Questionaire

It’s Time! Time to end the dieting roller coaster – time to get comfortable in your body – once and for all!

If you are ready – then I am ready to help you!

I invite you to a Complimentary “Get Acquainted with Inside Out” session. This is a private phone session where we will discuss YOU! I want to know about your situation, your challenges, your body and your goals.

If you are SERIOUS about ending this struggle, and are ready to shift into the positive mindset needed to establish a new relationship with food and put an end to emotional eating, then let’s talk!

Before we can set up the Get Acquainted session, I need you to fill this out completely. I really care, and am ready to help you.

Don’t wait – fill this out now and press submit. I will contact you within 24 hours, and we will set up the complimentary session.

Looking forward to talking to you soon!
Gerri

Let's Get Acquainted

Name
FirstLast
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone*
Email*
Enter EmailConfirm Email
How did you hear about me?
Have you ever been on a weight loss program? If so, please describe:
How much weight do you want to lose?
Do you have any cravings? If so, please explain:
Why do you want to make these changes now?
What is your biggest challenge?
Is there anything else you’d like me to know?
Captcha
Name
This field is for validation purposes and should be left unchanged.