[Smoothie] Smoothie Reset Feedback and Accomplishments Questionnaire

10-Day Smoothie Reset

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Feedback and Accomplishments Questionnaire

Name

Email Address

Why did you decide to join the 10-Day Smoothie Reset? What was going on that made you say “I’m going do to this!”*

What were you thinking, feeling, experiencing when you decided to join?

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What were your goals for the 10-Day Smoothie Reset?*

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Tell us about your successes! What have you achieved during the 10-Day Smoothie Reset? What are you most proud of?*

Did you lose weight or inches, get healthier, more energy, think better, improve workouts, does your truth-telling outfit fit different, etc?

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Did any of your stats change and if so by how much?*

Weight, body composition, measurements (belly button, 2 inches below the belly button, and smallest point on the waist).

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What has been the best part of the 10-Day Smoothie Reset?*

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How many smoothies have you been having each day?*

1 smoothie per day

2 smoothies per day

3 smoothies per day

Please rate your satisfaction right now with your:*

(1) Not at all satisfied. ( 2) Slightly satisfied.  (3) Moderately satisfied. (  4) Very satisfied. ( 5) Completely satisfied

Weight

Body Composition - body fat / muscle

Waist Measurement

Skin

Hair

Energy

Focus

Mood

Sleep

Please rate the severity of the following issues:*

(1) None / Very Mild (2) Mild (3) Moderate (4) Intense (5) Very Intense

Joint Pain / Achiness

Gas and Bloating

Cravings

Do you have any questions or feedback for us?*

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Is there anything else that you would like to share with us about your experience or about your weight loss journey?*

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May we use parts of your answers to help other people?*

Whether it's an explanation of benefits or to help them get at their own understanding of the issues by hearing someone else's words.

Yes, and you can use my full name

Yes, and you can use my first name

Yes, but with NO NAME

No, please don't share anything that I've written here

Other

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Feedback and Accomplishments Questionnaire

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