My Profile
Please fill-out this form to let us know a bit more about yourself. Be open, honest and provide as much information as possible
Email address *
Your Name *
Your age *
Your sex *
About you *
Write here about yourself. Let us know more about you. Provide as much info as possible (e.g marital status, number of kids and their age, who are you, what excites you and what not)
Health Status *
Do you have any health issues in the last months, or in general? Put as much detail as possible ( breaking nails, rashes , etc)
Training / Fitness *
Describe what type of activities do you enjoying doing? Do you currently do some training?
Goals *
What are you trying to achieve through this program? Take your time and be as specific as possible. Consider which areas in your life will improve with a better health. What are you long term-goals?
Challenges *
Where are you struggling? (E.g Continuous hunger either true or psychological as food is a means of satisfaction, Hypoglycemic, Reduced endurance, Reduced appetite for new beginnings and taking initiatives , etc.)
Why did you choose ketOntrack? *
Why did you choose to start?
How easily do you commit? *
Are you usually good at committing and completing challenging tasks?
Did you follow other similar programs? What went wrong? *
Was the issue with other programs and what do you expect from ketOntrack?
Hobbies *
Add you hobbies. E.g In the past I was participating in local theatre play and would like to restart this at some point.
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