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1. Healthy Weighs Goal Evaluation

1. Think back to the questions you answered on your goal sheet at enrollment and then complete the following:
Please check any/all that apply:

2. Circle what best describes your diet habits after completing Healthy Weighs.

3. Circle what best describes your exercise habits after completing Healthy Weighs.

4. How many times in a week do you eat fast food, carry out or in a restaurant?

5. My weight at the end of the program was (pounds):

6. In regards to the goals I set between session 1 and 2:

  I feel I met my goal. I did not meet my goal, but did make progress. I did not meet my goal or make any progress. I don’t remember my goal.
Nutrition Goal:
Physical Activity Goal:

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