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1. Let's get started with some personal information...

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2. Which one of my services are you interested in?

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3. How would you categorize your Fitness/Wellness Goal(s)?

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4. Do you have any injuries or limitations that may prohibit you from certain exercise(s)?

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5. Do you have access to a gym or fitness equipment?

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6. How frequently do you perform planned exercise?

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7. Rate your current commitment level.

[10] - I am willing to do whatever it takes to get to my goals (socially, financially etc.)

[0] - Now is not a great time. I have other priorities I need to focus on and working out/eating better is last on the list.

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i We adjusted the number you entered based on the slider’s scale.

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8. How would you rate your daily stress levels

[10] - My daily Stress is under complete control and does not effect my ability to perform daily activities

[0] - I am chronically stressed, overworked, and highly anxious

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i We adjusted the number you entered based on the slider’s scale.

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9. Rate your current dietary and nutritional habits.

[10] - I keep a food journal, understand my micro/macro nutrients and eat with the intention feeling better and performing optimally

[0] - I have no idea how many calories I consume daily. Take-Out happens regularly throughout the week, primarily comfort food

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i We adjusted the number you entered based on the slider’s scale.

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10. What do you feel you need the most help with?

0 of 10 answered
 

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