Lifestyle Audit
Please take 10 minutes to complete this questionnarie.
Back
Start
Gender
*
Male
Female
Age
*
Height (cm)
*
Weight (kg)
*
Body Mass Index
Body Mass Index Status
Basal Metabolic Rate
Sedentary: little or no exercise
Exercise 1-3 times/week
Exercise 4-5 times/week
Intense exercise 6-7 times/week
Very intense exercise daily, or physical job
Estimate your body fat % from the picture above
*
Back
Next
Goals & Activity
What would you like to achieve in the next 3-6 months?
*
Lose weight
Build muscle
Achieve a healthy body composition
Improve overall health
Improve nutrition habits
Increase energy levels
Reduce stress levels
Other
What barriers or challenges have stopped you achieving your goals in the past?
*
Lack of Time
No Motivation
Limited Knowledge
Unsupportive Environment
Inconsistent Routine
Overcoming Procrastination
Other
Q1) How would you rate your current fitness levels?
*
I feel unfit and out of shape, lacking regular exercise.
I consider myself fit, actively engaging in regular exercise and maintaining physical health.
Score Q1
Q2) How many hours do you currently exercise per week?
*
I’m not currently exercising
1-2 hours
3-5 hours
Score Q2
Q3) How many steps do you average per day?
*
I don't track my daily step count
Below 5,000 steps / day
5,000-10,000 steps / day
Above 10,000 steps / day
Score Q3
Q4) What best describes your daily work / occupation?
*
I spend a significant amount of time sitting at a desk.
My work involves being mostly on my feet and active throughout the day.
Score Q4
Q5) Do you engage in activities to improve flexibility and mobility?
*
I regularly incorporate stretching or yoga
I occasionally focus on flexibility
I rarely / never prioritize flexibility exercises
Score Q5
Back
Next
Nutrition
Q6) What best describes your current diet/eating habits?
*
I maintain a balanced and nutritious diet, incorporating a variety of healthy foods.
My diet consists mostly of processed foods.
I have irregular eating habits, often consuming unhealthy foods.
Score Q6
Q7) How often do you eat out or order takeaway food?
*
I rarely eat out or order takeouts.
I indulge in dining out or takeaway 1-2 times per week.
I frequently eat out or order takeouts, around 3-4 times per week.
Score Q7
Q8) Do you ever find yourself snacking / craving sugary foods between meals or at night?
*
Rarely or never
Occasionally
Frequently
Score Q8
Q9) How much water do you drink per day?
*
Less than 2 liters
More than 2 liters
Score Q9
Q10) Do you rely on coffee / energy drinks to sustain energy throughout the day?
*
I rarely consume energy drinks or coffee.
I occasionally have them to boost energy.
I frequently rely on energy drinks or coffee to stay alert.
Score Q10
Back
Next
Your Lifestyle
Q11) How would you describe your current energy levels throughout the day?
*
Low energy often fatigued
Moderate energy levels
High energy consistently alert
Score Q11
Q12) On average, how many hours of sleep do you get per night?
*
Less than 6 hours or poor quality
6-8 hours of restful sleep
More than 8 hours
Score Q12
Q13) How would you rate your stress levels on a typical workday?
*
Low
Moderate
High
Score Q13
Q14) How many hours per day do you sit and watch TV?
*
1-2 hours
3-4 hours
I don’t watch TV
Score Q14
Q15) How many hours do you spend on social media each day?
*
1-2 hours
3-4 hours
I don’t use social media
Score Q15
Q16) Do you smoke?
*
Yes
No
Q17) Do you drink alcohol?
*
Yes
No
Score Q16
Score Q17
Q18) Do you currently engage in any mindfulness or relaxation practices?
*
Rarely or never
Regularly a few times per week
Daily practice
Score Q18
Q19) How would you describe your morning routine?
*
I tend to hit the snooze button and react to the morning.
I wake up early and proactively engage in activities to start my day.
Score Q19
Q20) How do you typically spend your weekends?
*
I engage in outdoor activities, staying active and social.
I prefer relaxing and spending time at home during the weekends.
Score Q20
Total Score
Back
Next
You Have Scored
{totalScore145}%
Your Body Mass Index is
{bodyMass}
({bodyMass106})
Are you interested in receiving a personalized fitness and nutrition plan to achieve your goals?
*
Absolutely
Can I get more information
No, I’m good thanks
Back
Next
Your Results
Where should we email your results?
Email
*
Name
*
First Name
Last Name
Submit
Should be Empty: