Broad Goals Form
Please fill out the following form in preparation for your meeting with me. This is meant to be a board goal sheet so no need to get too specific now, we can talk more specifically about your goals in person.

By clicking the submit button at the bottom, your answers will be email directly to me. Thanks for taking advantage of this paperless version of the goal sheet. I look forward to speaking with you soon.

Regards,

Ben Lee
Email address *
Date: *
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Name: *
First and Last Name:
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Fitness and Wellness Goals
Example of wellness goals could be: Lower my blood pressure, or decrease my daily stress level.

Examples of fitness goals could be: Complete a 5 Kilometer run or walk, or improve my strength and physical stamina.
Goal 1.
Your answer
Goal 2.
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Goal 3.
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Goal 4.
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Goal 5.
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Benefits
Please list the benefits you expect from obtaining or reaching these goals.
Benefit 1.
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Benefit 2.
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Benefit 3.
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Benefit 4.
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Benefit 5.
Your answer
Obstacles
We all have things that keep us from achieving improved health and fitness. What do you see as obstacles in your life to improving your health and fitness?
Obstacle 1.
Your answer
Obstacle 2.
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Obstacle 3.
Your answer
Obstacle 4.
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Obstacle 5.
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Changes
If you could make a few small (or large) changes in your life, that would make a real difference in your health and fitness, what would they be?
Change 1.
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Change 2.
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Change 3.
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Change 4.
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Change 5.
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Additional comments:
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