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Health Quiz

Do you consider yourself a motivated person?

Yes

How much weight would you like to lose?

0-10 pounds

10-20 pounds

20-30 pounds

Greater than 20 pounds

I want to maintain my current weight

How much do you currently exercise?

Not at all

1-2 days per week

3-4 days per week

Greater then 5 days per week

What kind of exercise are you doing?

Cardio

Weights

Cross-training

Group Fitness Classes

Where do you struggle most nutritionally

I know what I should it eat but struggle doing it in real life

I struggle with snacking

I struggle with emotional/stress eating

I struggle with portion sizes

I do fine during the day and then overeat at night

Do you currently think you eat enough fruits and vegetables?

Yes

Do you currently follow any of the following eating styles:

Paleo

Keto

Intermittent Fasting

Vegetarian

Vegan

Other

Do you feel you have enough energy during the day?

Yes

How much sleep do you average at night?

<5 hours

5-6 hours

7-9 hours

>9 hours

Do you struggle with any of the following gut issues: bloating, gas, irritability, constipation?

Yes

Do you struggle with joint injury or issues such as popping, creaking or pain?

Yes

If asked to workout 30 minutes a day, how many days a week could you do this?

6-7

My schedule changes week to week

What is your email address (so I can send you results :)

Do you struggle with any of the following?

Lack Of Self Confidence

Body Image Issues

Feeling Supported

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