Name
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First Name
Last Name
Whatโs the best thing that happened to you since your last check-in due to being on this journey to improved health and wellness? What non scale victories did you notice in the past week?
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Reminder of how to win this journey:
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Agreed
Disagree
Rate your accuracy in measuring how much you were eating and sticking to the Program the past week *BE HONEST*
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Less than 5 (Poor) - did not measure most of my food at all
5-6 (Needs work) - eyeball estimated most of my food
7-8 (Good) - Measured ALMOST every single piece of food I put in my mouth using a scale and wrote it down
9-10 (Excellent) - Measured every single piece of food I put in my mouth using a scale to the last 0.1 gram and wrote it down
Rate for the past week
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ย
Poor
Needs work
Good
Excellent
1. Preparation
2. Single Ingredient Foods
3. Hydration
4. Exercise Quality
5. Going to Bed on Time
6. Work Stress
7. Home Stress
Things I struggled with this past week are....
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Things I did well this past week are...
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Things I would like to work on improving this upcoming week are...
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What needs to change this week so you can make progress on the area you'd like to focus on?
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So your coach can build your exercise schedule, what would you like to do for the upcoming week?
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ย
Workout
Walking / Get in my Steps
Running
Other - something else
No exercise this day
Wednesday
Thursday
Friday
Saturday
Sunday
Monday
Tuesday
On the days you selected "other" what activities would you added to your program?
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Other than your normal fitness & nutrition habits, are there any other habits you'd like to add (or continue) on your calendar for the upcoming week?
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NO OTHER HABITS - I will continue focusing on my main fitness & nutrition habits for now
Drink more Water
Go to Bed on Time
Walk/Get in More Steps
Meal Preparation / Weekly Planning
What time would you like to be in bed by ever night?
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What days / times would you like to meal prep in the week so we can check in on you and hold you accountable to it?
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Is there anything more I can do to be a better coach for you? What can I do to help you be more successful with your journey? If you were me helping you, whatโs one thing you would do differently (if anything)?
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Are you remembering to take ALL your supplements regularly?
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Yes!
Trying to - if I remember
No - but I would like to try some supplements to help me get better results
No - I am not on supplements at this time
Which of the following you have struggled with in the past?
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This matrix type is not available for legacy form layout.
You will receive a detailed step by step plan update for the upcoming week(s), but would you ALSO like to request a face-to-face (virtual/in-person) chat with your coach this week?
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No
Yes
To make the best use of our face-to-face chat time together, please take a moment to answer the following: What topics do you want to cover? and which is the most important of the topics? *Please be as SPECIFIC and DETAILED as possible*
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Anything else you'd like your coach to know about this past week? Any other notes, comments, questions or concerns?
Should be Empty: