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Daily Assessment- Before
Before session assessment questionnaire
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* Required
Date
*
MM
/
DD
/
YYYY
*
Time
:
AM
PM
Last Name
*
Your answer
First Name
*
Your answer
How does your body feel physically right now?
*
BAD
1
2
3
4
5
EXCELLENT
How prepared are you for today's session?
*
NOT AT ALL READY
1
2
3
4
5
VERY READY
How many hours of sleep did you get last night?
*
Your answer
How was your quality of sleep last night?
*
VERY BAD
1
2
3
4
5
VERY GOOD
What did you eat before today's session? What time?
*
Your answer
How do you feel about what you have eaten today?
*
VERY BAD
1
2
3
4
5
VERY GOOD
What is your mood like today?
VERY UNHAPPY
1
2
3
4
5
VERY HAPPY
Clear selection
Any other personal issues that might influence your session today?
Your answer
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