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Hello:
You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
 
 
 
 
We want you to succeed!! Just like every top athlete has a coach, we're here to support you achieve "Your Gold Medal" - the BEST YOU! Fill out the questions accurately and honestly as this will help you to reach your ideal weight.
 
 
* Day and date. Please fill out like this: Monday, August 15, 2016
   
 
 
What was your weight this week?
   
 
 
* What did you have for breakfast? Add the number of carbs behind each item.
   
 
 
* What did you have for lunch? Add the number of carbs behind each item.
   
 
 
* What did you have for dinner? Add the number of carbs behind each item.
   
 
 
* What snacks did you have and how much? Add the number of carbs behind each item.
   
 
 
* How many carbohydrates did you have total?
   
 
 
* Did you take psyllium today?
 
Yes
 
No
 
 
* Did you take two tablespoons of cold pressed oil today?
 
Yes
 
Now
 
 
* Did do any exercises? If so, what and for how long?
   
 
 
* Please describe extensively and in detail how your day went today. (How did you feel? What challenges did you have? What happened?)
   
 
 
* What WINS did you have today? Find as many as you can and describe them detailed. The more you validate your success in life, no matter how small, the more successful you will be.
   
 
 
Comments, feedback or questions:
   
Well done! You're a step closer to having the body you want ;-)