Coaching Application Survey
I'd like to get to know you a little better, so I know how to help you! Just answer these few questions before we go any further!
Name (First and Last)
How would you describe your relationship with food?
I think about what foods to eat based off how they will affect my weight/appearance. I worry about calories when choosing my meal.
I have an okay relationship with food. I sometimes worry about it, but I also let myself indulge.
I struggle with over-eating and then restricting because I feel guilty.
I have a great relationship with food. I eat what I want, when I want, and choose foods based off how they'll satisfy me both emotionally and physically.
How is your relationship with exercise?
I don't exercise
I have a planned out fitness routine, but I'm flexible if it changes.
I have a planned out fitness routine, but I get stressed if it changes.
Do you have any fitness goals, currently?
What do you hope to gain from working with me?
On a scale of 1 to 5 how ready are you to change? (5 being most ready)
So ready! I'll do whatever it takes
How is your body image?
Great. I feel great about how my body looks, all the time.
Eh. Some days I feel good about my body, other days I feel bad about my body.
Terrible. I always feel bad about how my body looks
Are there any health issues I should know about?
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