WE ARE looking forward to our call!

We are so excited you're here! If you could take a few minutes to answer the following questions, it would really help us out! Your responses will help us provide resources + education for you as you embark on your wellness journey. We're so grateful to link arms and help you on your way!

Click the button below now to fill out the form, and we'll dig deeper into our upcoming call.

Wishing you abundant health & blessings, Colette & Tony

Fill out the form

What's the ONE thing you most want to improve in your wellness?*

What steps have you taken toward reaching that goal?*

What product, regimen or action do you feel has helped you the most?*

What is your favorite Young Living product so far, and why?*

What has that favorite product done for you?*

Got more than one favorite? Share what & why here!*

Describe your activity level*

I am a workout fanatic

I get at least 30 minutes of moderate exercise 5-7 times a week

I get at least 30 minutes of moderate exercise 1-4 times a week

I exercise in spurts, but nothing regular

I rarely get regular exercise

How familiar are you with product ingredients*

I read all the labels

I am familiar with some ingredients I avoid, but not an expert on the topic

If it's on the shelf in the store, I assume it is safe

How would you describe your mental health?*

I feel peaceful and not anxious trusting the process and God.

I feel moderately anxious - I would like to have more strategies to maintain my peace

I feel very anxious most of the time - I would like to have more strategies to maintain my peace

I have sadness/depression that mildly affects my ability to fulfill my responsibilities

I have sadness/depression that strongly affects my ability to fulfill my responsibilities

I cannot fulfill my responsibilities at all due to my sadness/depression

Prefer not to answer

How important is it to you to improve your wellness?*

Very important - my qualify of life would definitely be affected

Moderately important - I would like it to be better

Not important enough for me to make changes

Would you be willing to make a few strategic changes and stick to it for 90 days?*

Yes

I think so

No way - I'm not changing anything right now

Please provide your Young Living member # *

Anything else you'd like me to know ahead of our call?*

Colette Polignone

USA
443-681-7071 • hello@coletteandtony.com