Questionnaire: Journey Day 1 Call
(To understand my approach to weight-loss, see my services page here: https://partakemealplanning.com/all-coaching . I also share tons of free strategies on social media at www.instagram.com/partake_foodie )

Please share some basic information below. This will allow me to sense-check whether you are committed to your Journey Day 1. If I think we're a good fit, I'll reach out through by phone to either schedule your free 1-1 Journey Day 1 call, or confirm the timeslot you've selected. 

There is no obligation to do any coaching after this. Think of it as a free strategy session, tailored to you!

I will be prepared to give 100% during our call, so that you walk out with a clear action plan for yourself. I can also address any questions about what it would look like if we worked together long-term. If you are prepared to stay present during this coaching session and give 100% as well, then I'm excited to work with you!

Answer the following questions to the best of your ability. It should take 3-4 minutes.
Your Full Name *
Your Email Address: *
Date of Birth (MM/DD/YY) *
Phone Number (So we can schedule your strategy session, and as a back-up for video-call.) *
How many meals per week are home-prepared or brought from home? By contrast, how many meals would you say were made by restaurants or fast-food places? *
How confident do you feel in the kitchen on a scale of 1 to 10? Why? *
How would you rate the majority of your eating decisions, on a scale of 1 to 10?

1 = unplanned, impulsive, binge-y, emotional, or mostly stress-related

10 = purposeful, aligned with my health goal, balanced, and/or mostly based on hunger and fullness levels *
Why did you give the rating you did in the previous question? *
What do you do for work (paid or unpaid)? (For example, a full time job, part time job, caretaking for a dependent, volunteering for an organization, raising children or grandchildren, etc).

Do you feel like this impacts your ability to succeed in your weight-loss goal? If yes, provide a brief description of how.
 *
Please share your most recent height and weight recorded. If you have measurements, feel free to share them here as well. *
What do you want to achieve with your health over the next 12 months? Why is this so important to you right now?
 *
Besides what you've already shared, what else is holding you back from getting there? Why haven't you gotten "over the hump"?
 *
Tell about the things you've tried in the past to overcome this. What did you like OR dislike about these approaches and programs?
 *
How do you feel like a coach can help you overcome your biggest obstacles?
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What do you think will happen if you don't take action? What is the most realistic outcome?*
IMPORTANT: Give this some real thought ("I won't reach my goals" is NOT a powerful driver). How will your life look if nothing changes?
 *
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