importance (1-10) 1 = not very important 10 = non-negotiable
On a scale of 1-10, rate how ready you are to enter a health coaching relationship right now.
I am open-minded about learning new ways of eating, moving, and living.
I can commit to changes that feel uncomfortable, unusual, or unconventional.
I will communicate and negotiate with my health coach as an equal partnership, and feel confident to ask for what I need.
I have a high level of self-awareness.
I will keep my word to my coach and to myself.
I understand that health coaching is an investment in myself, and I will not suffer about the financial cost.
Beverages. How many glasses or servings of the following do you have in a day, week, or month? Please provide quantity and frequency.
On a scale of 1 to 10, how would you rate your stress level?
Sleep quality.Check all that apply:
Sleep quantity. How many hours of sleep do you get most nights?
What time do you typically go to bed?
What time do you typically wake up?
Are you a competitive athlete?
Do you usually enjoy your work?
How many hours a day do you work?
Do you have any allergies or sensitivities?
Do you smoke?
Do you partake in recreational drugs?
Females: Are you or could you be pregnant?
