Slide Better body
Better mind
Better you
Better life
Free yourself with

Application Form

Only fill in if you are serious about making a positive change to your lifestyle

    PERSONAL INFO

    All must be answered

    GOALS

    All must be answered

















    LIFESTYLE

    All must be answered




    Do you currently smoke?

    Do you drink alcohol?


    Do you generally feel that you are getting enough sleep?

    EXERCISE

    All must be answered

    Do you currently exercise ? Yes / No?


    If you do not currently exercise have you ever exercised?


    Can you walk briskly for 30 minutes without fatigue?
    Can you jog for 20 minutes without fatigue?


    NUTRITION

    All must be answered


    MINDSET

    All must be answered


    ATTITUDE

    All must be answered