Update Pre-Session Form - Coaching with Kathleen
Please complete all questions on form TWO DAYS PRIOR to your next session
Email address *
Full Name *
Your answer
What positive changes have you noticed since your last appointment? *
Your answer
What are your main concerns at this time? *
Your answer
Have there been any changes with weight and/or waist size? *
Your answer
How is your sleep? *
Your answer
Do you have constipation or diarrhea? Gas or bloating? Which? *
Your answer
How is your mood? *
Your answer
Is your energy level higher or lower lately? *
Your answer
To what do you attribute this energy level? *
Your answer
Are you in any pain on a regular basis? Please explain *
Your answer
If this is ongoing pain, is it better, same, or worse than before? *
Your answer
Are you receiving good support from those around you for the changes you are making? *
Your answer
Are you taking all supplements consistently? Any concerns? *
Your answer
What do you see as a significant barrier to you making more/faster progress toward your health goals? *
Your answer
Are you cooking more? *
Your answer
What do you crave? What are you doing or feeling when you crave? *
Your answer
Breakfast *
Your answer
Lunch *
Your answer
Dinner *
Your answer
Snacks *
Your answer
Liquids *
Your answer
Any other comments you wish you share? *
Your answer
Do you have particular questions or topics you would like to cover in our next session? *
Your answer
Do you have particular questions or topics you would like to cover in our next session? *
Your answer
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