Bodyfat % (if you know it)
What is your primary fitness/nutrition goal? (ex: overall health, lose weight or fat, gain muscle, body composition, athletic performance, etc.)
Do you have any secondary fitness/nutrition goals?
What is the drive motivating you to accomplish your nutrition goals?
Do you think you are underweight/overweight? If yes, how many lbs would you like to lose/gain?
Do you have any health related problems (diseases such as diabetes, high blood pressure, cholesterol, etc or body stresses such as trouble sleeping, difficulty breathing, joint pain, etc.)?
How would you rate your current nutrition (Scale 0-10, 0 being terrible and 10 being perfect)?
Where would you like your nutrition to be?
Describe your biggest nutrition struggles:
What do you hope to get from our nutrition meeting or from nutrition coaching?
Do you currently follow a special dietary plan such as low carb, vegetarian, paleo, zone, etc? If so what? If not currently, have you ever?
Are you comfortable with the way you eat? Yes/No and Why?
Do you take any supplements?
How much water do you drink per day?
Do often you skip meals?
How often do you eat fast food/out at restaurants?
How would you rate your eating behaviors (such as mindfulness, eating alone, binging, snacking, etc).
How would you rate your current exercise & activity level?
How would you rate your current recovery (sleep, rest, mobility, stretching, etc)?
How would you rate your food & cooking skills (such as meal planning, meal prep, knowledge of food, experience and ability to cook many different ways)?
How would you rate your life skills (such as relationships, work performance, conflict resolution, dealing with stress, etc)
How would you rate your mindset/physchology towards health/fitness/food/self? (ex: all or nothing, food is bad/good, ability to manage/express emotions, etc)
How would you rate your current environment related to reaching your health/fitness goals? (your home, family members, friends, and workplace)
Are there any foods you cannot eat (allergic/intolerant)?
Are there any foods you absolutely refuse to eat (personal choice)?
What foods do you really like?
What do you find to be most challenging about committing to a workout or nutrition regimen?
How important are your fitness & nutrition goals? 1-10
What will the benefits of reaching your goals be?
What will you have to sacrifice to get there?
How confident are you that you can change your nutrition and exercise habits?
Please add any additional info you feel may be relevant to understanding your nutritional health:
Don't forget to send a 1 week food journal to firstname.lastname@example.org. We'll review your answers and be in touch to setup a time to chat.