Do You Drink Coffee In The Morning?

• Yes 1-2 cups
• Yes 3-4 cups
• Yes 4+ cups
• NO

Do You Currently Do Any Form of Exercise?

• Does Walking to My Car Count?
• A Little – 1-2x Weekly
• Moderately – 3-4x Weekly
• YES!!! – 6x Weekly

Do You Drink Water During The Day?

• Yes 1-2 glasses
• Yes 2-3 glasses
• Yes 4+
• Not too much, maybe 1 glass at most

Have you been on more than 1 diet in the last 2 years?

• Yes
• No
• Not in the last few years
• I have never dieted

Are you Male or Female?

• Male
• Female

Which Body Type Best Describes You?

• Skinny
• Semi-muscular
• Chunky

Which Body Type Best Describes You?

• Skinny
• A Little Bit Extra
• Overweight

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