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Boot Camp Evaluation

Name:		Email Address
Finish Date of Cleanse:		Length of Cleanse:
Cleanse Name:
Rate your Nutritional Cleanse:
1. On a scale of 1-10 (ten being the best) how would you rate your nutritional cleanse?

2. Did you compete the cleanse? Y/N
	Yes \| No
3. Your results:
Weight lost:	lbs.
Fat lost*:	lbs. *if measured with body composition scale.
Inches lost:	inches
Clothes fit better? Y/N Yes \| No
More energy? Y/N Yes \| No
4. What did you like best about your cleanse?

5. What did you like least about your cleanse?

6. Please describe your cleanse experience (before, during, and after):

7. Were the instructions clear? Y/N
	Yes \| No
Please explain

8. Did you feel supported by others (family/friends) during the cleanse? Y/N
	Yes \| No
9. Did you chose the right program for your lifestyle? Y/N
	Yes \| No
Please explain

10. Would you recommend this program to your family or friends? Y/N
	Yes \| No
11. Are you interested in doing another cleanse in the future?

How soon?
12. Are you interested in speaking with Steve about (check all that apply):
	Immune support Hormonal balance Sports nutrition Peak performance Healthy snacks on-the-go Heart health Men’s health and vitality Low-sugar fruit drink for kids and adults
13. Summarize your experience; add further comments, suggestions, or questions:

14. If there important people in your life who would benefit from information about nutritional cleansing, please fill in their names and email addresses below. I will email them the link to the life-changing BABC Nutritional Cleansing web pages.

For More Information, Contact us at (802) 764-5848 or e-mail adventurefit@burlingtonbootcamp.com