Your Metabolism
Please take your time and answer the questions, the more you share, the more value you will get out of our future nutrition and lifestyle recommendations. (For instance, a slow metabolism requires a different nutrition than a fast one.) // After I review I will be in touch. / Because I get back to each person individually and I currently receive a lot of messages, the reply can take up to 14 days. // THIS INFORMATION IS CONFIDENTIAL and will only be reviewed by Jennifer Witte.
1) Do you think it's easy for you to lose weight? *
2) Has your weight been stable for at least three months (includes a variation of ± 3 kg/6 lbs)? Note: If you don't weigh yourself: Great! Please make a guess. *
3) For how long has your weight been stable (includes a variation of ± 3 kg/6 lbs)? Note: If you don't weigh yourself, make a guess. (Skip this question if you answered the previous with "no" or "up and down")
4) Have you ever tried diets or just limiting calories in order to lose weight? *
5) Have you ever dieted or limit the calories for more than 14 days in a row? (Note: Skip this question and continue with number 7 if your answer was "No" in the previous question.)
6) How many diets or low calorie phases have you done so far?
7) How regular is your bowel movement? (No diarrhea; Please choose "other" and describe if you have digestive issues) *
8) How often do you exercise for at least 30 minutes? (Medium to high intensity) *
9) On average, how many of your meals come with veggies or fruits? *
What's your goal? Please describe it as detailed as possible. *
Your answer
On a scale of 1-10, how ready are you to commit to yourself, your growth and your life and working with a coaching? *
Is there something else that you'd like to share with me? (diseases, intolerance, etc.) *
Your answer
How did you find out about me? *
Age *
Your answer
Full name *
Your answer
E-Mail *
Your answer
Phone number *
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy