VIP Mastermind Questionnaire

First Name

Last Name

Phone

What is your age?

What is your height (in inches)?

What is your body weight (in pounds)?

What is your approximate body fat percentage?

How many years have you been exercising/training?

What style of training do you adhere to on a regular basis?

Are you currently on hormone optimization therapy?

Yes No

What delivery system are you using?

What is your weekly dosage of testosterone?

Do you currently use Therapeutic Peptides?

Yes No

Please list all other supplements and medications you are currently using.

Have You Worked With An Online Coach Before?

Yes No

Please describe your experience with that coach/program

What does the word vibration mean to you?

Please describe your ultimate goals.

What do you want your life to look like after 12 months of working with me?

On a scale of 1-10, how committed are you to achieving your highest and best life?

What is the average monthly dollar amount you spend on your own personal healthcare?

Are you committed to making a $50k investment payable in advance KNOWING your life would absolutely change forever after 12 months of working with me?

Yes No

VIP Mastermind Questionnaire

A Week in the Life of

Jay & Monica Campbell