PHIT LIFE SURVEY

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PHIT LIFE SURVEY

Welcome!

Thank you for joining the PHIT life family! I look forward to learning more about you. I have a series of questions that will help me gain insight on where you are to help you get where you are going. No answer is a wrong answer! Please be honest with every question. Let's get started!

I believe I eat *

healthy

Fairly healthy

unhealthy

When I think of the word wellness I think of *

I eat ___ fruits, daily *

1-2

2-3

4-6

I eat ___ vegetables, daily *

1-2

2-3

4-6

I eat bread, potatoes, and/or rice *

1x a day

2x a day

3x or more a day

I eat sweets *

1x a week

2x a week

3x a week

I drink ___ cups ( cup=8 oz) of water daily *

2-3

3-5

more than 5

I believe I know how to correctly portion my plate for healthy ratios *

Yes

I would say my biggest struggle with weight loss is *

Overall, I would like to lose ___ pounds *

When I lose ___ pounds I will be able to *

I desire to live a healthy life because *

With my current schedule for family, work and fun, I would say I'm *

active

sedentary

I get moving enough to challenge my current abilities but I could move more

Thank you for taking the time to complete this survey. If you have not already, please go to your email to schedule your first one on one coaching session. We are going to crush your goals starting now! *

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