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INITIAL QUESTIONNAIRE

 

 

 

 
ACTIVITY ASSESSMENT

Please list your 3 main goals:
Equipment Accessibility
Please select from the lists below which of the following you have access too:
NUTRITION ASSESSMENT
In this nutritional assessment, our goal is to have a clear and accurate idea on what types of foods you are consuming. In order to maximise results, we ask you to be 100% accurate through this assessment.



Nutrition Diary:
Over the next 2 days, please document every item you consume in the app TrueCoach. (no matter how small, it must be recorded). Things to include: soft drink, olive oil, chocolate, nuts, milk in coffee. Everything that is consumed.
This is an exercise of honesty, so please do your best to complete this as honestly as possible.
If eating out, please do your best to list as much info about the meal as possible.
WELLBEING ASSESSMENT
The following is the final assessment we will need to go through before we can properly prescribe your new lifestyle plan. As with the other assessments, we urge you to please be 100% accurate in explaining your current situation.
In 1 – 3 words, describe how you feel when:
Which of the following apply?
List the 3 biggest stressors in your life:
Have you lost large amounts of weight before?