Please answer all questions honestly!
Who is checking in?
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First Name
Last Name
What is today's date?
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Year
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Month
Day
Date
What time is it?
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:
Hour
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10
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30
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50
Minutes
AM
PM
AM/PM Option
Rate yourself 1 to 5 on
Nutrition
Compliance
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5
Rate yourself 1 to 5 on
Mindset
Compliance
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Rate yourself 1 to 5 on
Training
Compliance
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5
What are you grateful for?
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What area do you feel needs improvement this coming week?
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What negative patterns do you feel like are holding you back?
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Where can I support you more/where do you feel like you need more help?
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What are 3 wins for the week?
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What are 2 lessons you learned or realized about yourself or others?
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What will you do to become better for this week?
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Submit Form
Which of the following do you feel like you have gained positive development in?
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Health & Fitness
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5
Clarity
6
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Courage
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Energy
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20
Productivity & Time Management
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25
Stress Mangment
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30
Taking Breaks from Long Tasks
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35
Relationships
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40
As agreed upon being accepted into the program, how do you feel about your level of engagement in the LYTTC FIT Queens Instagram Community Group?
*
Are there any changes or tweaks you believe need to be made to your program? (Be specific)
Do you require a coaching call this week?
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No
Group
Private
Any notes or comments?
Finally,
Please press SUBMIT below to save and send this form. It you don’t see THANK YOU afterwards, then the form has not been saved and sent.
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