1. Have you tried other weightloss programs with little or no success? Yes No
2. Does your body weight stop you from doing things you would like to? Yes No
3. Do you ever eat more than you need? Yes No
4. Are you motivated to lose a significant amount of weight and keep it off forever? Yes No
5. Are you dedicated to success and want to change your eating habits and learn new ways to be healthy and happy? Yes No
6. Do you want a personalized program designed by an experienced Medical team? Yes No
7. Looking at our Ideal Weight Chart, do you need to lose 5 kilos or more? Yes No
