Hi, beautiful...

Welcome and thank you for joining the Health Hub!

I’m so excited that you’re making an investment in your health. And I know that you’re going to love the incredible resources inside the Health Hub that are now available to you for life. Once we’re ‘friends’ on Facebook, I’ll add you into our Hub Community Page where you can connect with like minded individuals and share your journey.

CLICK HERE to head to your Members Area and your unique password is:

HH0610

Below is a Health Hub Survey. This is a great way for you and me to track your results you’re looking for.

I’m here to help you! If you need extra support on what to eat, or you’re working through your mindset work and need to discuss it with someone, please reach out to me on Facebook Messenger and I can support you.

I'm so happy you're here!

Health Hub Survey

Name

First Name

Last Name

Email Address

Date of Birth

YYYY

Phone Number

What's the best way to stay in touch with you?

Current weight

Height

How many hours sleep do you get on average?

Rate your immune system out of 10

When is your energy at its best?

When do you feel the most exhausted?

Do you have any digestive issues?

How many litres of water do you drink per day?

Rate your diet out of 10

What foods do you eat most often?

Do you drink alcohol, soft drink or coffee?

What dietary habits would you most like to change?

Short term goals

Long term goals

What are you willing to change in your life to ensure you achieve these goals?

Anything else you would like to share?

CONFIDENTIALITY - I, the client, acknowledge that Angela Simson, as my Health Coach will keep all information exchanged during the program sessions or in any written form with strict confidentiality. I, as the client, further acknowledge that the information provided to me is designed to meet my own personal dietary, health and fitness needs and is not suitable for other individuals and will not be transferred, copied or given to another person.

Client Name

Client Virtual Signature

Date

YYYY