Rebalance: Registration Form

Rebalance-Programm

Registration

Name:

Surname:

Birth Date:

Street:

Postcode:

Location:

Phone:

Mobile:

Email:

Current weight in kg:

Desired weight:

Size in m:

Current BMI:

Desired rebalance program (one or two years):

Group course (140.-/month per person)

Group course (140.-/month per person) - with exchange of experiences and group motivation.

Where would you like to attend the group course?

Individual coaching (140.-)

Individual coaching (140.-) - Individual and flexible meetings over 2 years.

I would like to shorten the duration from 24 to 12 months. This is only recommended if your overweight is <10%, i.e. BMI < 27.8.

Analysis of causes for overweight (140.-/once)

Analysis of causes for overweight (140.-/once) - analysis of your individual overweight causes based on the analysis questionnaire as well as a telephone consultation about suitable therapy options and their chances/benefits for you. Clarification of your questions. If you subsequently decide to participate in a group course or individual coaching, the costs for the analysis will be waived.

Next steps:

After registration, you will receive the cause analysis questionnaire and information on the type of course you would like to attend.

General terms and conditions read and accepted.*

General terms and conditions read and accepted.

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