1. Surveys
  2. 2017
  3. May
  4. F
  5. Ft
0%
Questions marked with a * are required Exit Survey
 
Personal Information
* Name
 : 
* Team Name
 : 
* Phone : 
* Email Address : 
 
 
Tell us a little more about yourself - So, we can customize your plan
* Height (in cms)
 : 
* Weight (in Kg)- Week 1
 : 
* Target Weight (in Kg)
 : 
 
 
Are you following the given diet plan - Week 1
Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
* YES
* NO
 
 
Are you following the given diet plan - Week 1
Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
* YES
* NO
 
 
Which form(s) of activity are you engaging in....?
Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
* Walking
* Running
* Swimming
* Yoga
* Aerobics/Zumba
 
 
Number of minutes you engaged in physical activity on a daily basis....
Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
* <30 minutes
* 30-90 minutes
* >90 minutes
 
 
Number of hours of sleep received on a daily basis....
Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
* <6 hours
* 6-8 hours
* >8 hours