3 Pillar Health | Nate Fagen

Full Name *

Age *

Email *

Occupation *

What are your top 3 health and fitness goals? (Examples: Lose weight, gain muscle, improve energy, etc.)

What is your biggest struggle when it comes to health or fitness? * *

What areas of your life do you lack confidence in the most? *

What have you tried in the past to reach your goal? *

How many times per week do you exercise? *

How would you describe your current diet? (Examples: Balanced, inconsistent, unhealthy, etc.) * *

Are you open to incorporating faith into your health journey? *

Yes

No

Not Sure

What interests you most about the Temple Transformation Program? (Examples: Faith-based coaching, accountability, personalized plans, etc.) * *

What motivates you to make a change right now? *

Have you ever worked with a coach or followed a structured program before? *

Yes

No

NATE FAGEN