Claudia Scali Fitness and Transformations
Upon completing this form, I will follow-up with a consultation call to discuss your goals.
Name *
Your answer
Email Address *
Your answer
Skype ID/Phone Number *
Your answer
Explain your current situation. How are you feeling? What are your concerns? What are your main complaints? *
Your answer
What would you love to see happen in your life over the next 6 months? *
Your answer
What do you think needs to shift or change for this to happen? *
Your answer
How many hours do you sleep per night? (on average) *
Your answer
Do you wake-up through the night? If so, what time? *
Your answer
Do you experience any of the following on a daily basis? (check all that apply) *
Required
Please rate your average daily energy levels on a scale of 1-5 *
Somebody hold my eyelids open
Bouncing off the walls
Please let me know which areas you would like support/coaching (check all that apply) *
Required
How many times do you dine out per week? *
Your answer
Do you have any food intolerances? *
Your answer
Do you workout regularly? If so, how many times per week? *
Your answer
Are you excited to workout and complete your workouts feeling satisfied? *
Your answer
Do you believe you have a healthy relationship with food? *
Your answer
Do you get anxiety over food choices or making choices in social settings? *
Your answer
How would you rate your stress level on a scale of 1-10 *
Low Stress
Extremely High Stress
Do you believe that dining out sabotages your goals or healthy eating? If so, why? *
Your answer
Thank you for completing the form! I will be in touch with you shortly.
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