Weight Loss Coaching - Initial Questionnaire
This is a way for you to start taking back control of your eating, exercise and overall health.
Be honest with yourself and take 15 minutes or more to answer these questions about you, your eating and exercise habits, your stress and recovery patterns and your social and accountability circle.

Simply answering these questions will give you great insight into your own strengths and weaknesses.
Sign in to Google to save your progress. Learn more
Email *
First name
Last name
Your concerns about your health, weight, body image etc
List any thoughts or concerns you may have about your health, your weight, your family, your exercise level and how you perceive your body in general.  (eg - any illnesses, anxieties etc)
Overall goal
Taking into account what you answered above, what is the overall goal you want to achieve?
What have you tried in the past?
What steps, plans, courses etc have you tried in the past to achieve your OVERALL GOAL?
Which have worked in the past?
Which of these steps, plans, courses etc have worked well for you in the past?
Which have not worked in the past?
Which of these steps, plans, courses etc have NOT worked well for you in the past?
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy