'30 Day Reset' written in black font on transparent background.

Daily Check-In Form

Please complete the following form. If you need to contact the LightHouse team directly for any reason, then please email info@l-h-s-c.com or text (910) 902-1459.

Name

First Name

Last Name

Did you eat only whole foods today?

Yes

No

What was your favorite meal today?

Breakfast

Lunch

Dinner

Snack

Pertaining to the question above, share what you had.

Share a "win" you had today.

Share a struggle you had today.

Use the space below for any comments or questions.