Lindora Clinic since 1971 personalized weight management
 
 
Name Age Email
Home phone Work phone Cell phone
Occupation Height Current weight
 
Total pounds lost on
the Lindora program
Starting weight
with Lindora
Before photo
Largest dress/pant size Current dress/pant size After photo
 
 
 
 
 1. What health improvements have resulted from your weight loss?
 
 2. Was there a particular incident or event that inspired you to lose weight?
 
 3. What was your worst weight-related experience as an overweight person?
 
 4. What was your goal when you went to Lindora? Did you achieve it?
 
 5. How many other weight loss program(s) had you tried before Lindora? Please name them:
 
 6. How did you learn about Lindora ?
 
 7. How was Lindora different from other programs you’ve tried?
 
 8. What three words would you use to describe Lindora and/or your results on the program?
 
1.  2.  3. 
 9. Why do you think you succeeded on the Lean for Life program?
 
 10. What “tips” would you give someone who is just beginning the Lean for life program?
 
 11. What Lindora products or resources (i.e. protein bars, book, daily action plan) did you enjoy using most?
 
 12. Is there a Team Lindora member who was especially helpful?
 
 13. What is the best reaction or feedback you received after losing weight?
 
 14. If someone who has lost faith in his or her ability to lose weight asked you about Lindora, what would you tell them?
 
 15. What is the biggest change in how you look or feel since losing weight?
 
 16. What was the greatest challenge or obstacle you faced while losing weight? How did you overcome it?
 
 17. What three words would you use to describe yourself at your heaviest weight?
 
1.  2.  3. 
 18. What three words would you use to describe yourself at your heaviest now?
 
1.  2.  3. 
 19. While you were losing weight, what kept you motivated to stay on the program?
 
 20. What can you wear today that you could not (or would not) have worn at your heaviest weight?
 
 21. What’s the greatest compliment you’ve received about your weight loss success?
 
 22. How have your life—and health—changed as a result of losing weight?
 
 23. Is there anything else you’d like to tell us about your Lindora experience?