1. Name
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First Name
Last Name
Mobile Phone (Textable Number)
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(###)
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2. Email
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"LOOKING BETTER" BASELINES: Use the link BELOW to schedule BASELINE PHOTOS [if you haven't already].
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COPY & PASTE THIS LINK INTO ANOTHER BROWSER WINDOW AND SCHEDULE YOUR BASELINE PHOTOS:
https://go.oncehub.com/conversationwithcoach
"BODY COMPOSITION" BASELINES: Use the link BELOW to schedule INBODY MEASUREMENTS [if you haven't already].
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Everyone should schedule TWO MEASUREMENTS:
1) one for NOW (baseline check), and
2) one for 6 weeks from now (progress check)
COPY & PASTE THIS LINK INTO ANOTHER BROWSER WINDOW AND SCHEDULE YOUR 2 INBODY MEASUREMENTS:
https://go.oncehub.com/inbody
"PERFORMING BETTER" BASELINES: If you have them, enter your BASELINE PERFORMANCE NUMBERS here.
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SAMPLE DATA YOU MIGHT INCLUDE:
Baseline strength/lifting numbers:
Retest strength/lifting numbers:
Baseline bodyweight-exercise numbers:
Retest bodyweight-exercise numbers:
Baseline metcon/conditioning numbers:
Retest metcon/conditioning numbers:
Please take this Enneagram Personality Test, then tell us your top result below (~10-15 minutes to complete):
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COPY & PASTE THIS LINK INTO ANOTHER BROWSER WINDOW:
https://www.truity.com/test/enneagram-personality-test
Describe your relationship with food in detail.
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If you’ve succeeded in the past, what were the top reasons why?
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If you’ve failed in the past, what were the top reasons why?
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Diets (or nutrition plans) I’ve tried in the past, and LIKED: what are they, if any?
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Also, please tell us WHY you liked them.
Diets (or nutrition plans) I’ve tried in the past, and DID NOT like:
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Why didn’t you like them?
What’s your current weight, and goal weight?
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What’s the most you’ve weighed in your adult life?
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Which meals do you eat regularly?
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Check all that apply.
Who SHOPS for food in your household?
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Check all that apply.
Who PREPARES the food in your household, up until now?
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Tell us all that apply:
Who WILL BE preparing the food in your household, in the coming weeks?
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Tell us all that apply:
Where do you shop for food (most commonly)?
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Do you follow any special diet or have diet restrictions or limitations for any reason (health, cultural, religious or other)?
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Please list any food allergies, sensitivities or intolerances:
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Healthy foods I love (want to eat often):
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Healthy foods I hate (don’t want to eat, ever)
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What are your top food cravings (what specific foods, brands, restaurants, etc)?
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Based on how you eat on a regular basis, check all that apply:
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How frequently do you drink the following?
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"I do better with (choose one):"
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Rules, clear boundaries, "bright lines"
General principles, no rules, & flexibility w/ "allowed vs not allowed"
Choose one or more:
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The eating habits that are the most difficult for me are:
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The eating habits I’m most pleased or proud of are:
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When you make excuses, what excuses do you make?
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Which do you prefer in a coach:
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To improve my health, I’m ready/willing to:
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CHECK ALL THAT APPLY.
What’s your #1 greatest reason WHY you must succeed in this?
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Be as brutally honest and transparent as possible. Your openness helps us to help you.
What're the top 1-2 things that DERAIL or UNDERMINE your healthy-eating efforts?
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Or, to put it another way, what are the BIGGEST challenges for you?
If situations or circumstances AT HOME often derail you OR threaten to derail you, what are they?
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If situations or circumstances AT WORK often derail you OR threaten to derail you, what are they?
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Who do you live with?
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Spouse
Spouse and kids
Kids only
Boyfriend or girlfriend
Platonic friend or roommate
Alone
Give us the best descriptor(s) for the people you live with:
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Indifferent
Slightly supportive
Very supportive
“We are each others’ worst enablers”
Actively opposed to my nutrition aspirations
Actively trying to sabotage my efforts
If you have kids, what is their age range?
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Choose all that apply.
What medications are you taking, that might be a factor in your plan or progress?
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What medical conditions OR circumstances (pregnancy, etc) do you have, that might be a factor in your plan or progress?
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