On a scale of 1-10 with 10 being excellent and 1 being poor, please answer these assessment questions about yourself.
1. In general, how would you rate your current level of health?
2. Compared to one year ago, how would you rate your health now?
3. How would you rate your satisfaction with your health at this time?
4. How would you describe your satisfaction with your current level of fitness?
5. How do you feel about your blood sugar level throughout the day?
6. How would you describe your current level of stress?
7. How would you describe your satisfaction with your current eating and nutritional habits?
8. How would you describe your satisfaction with your current weight?
9. How would you rate your success at eating 7-13 servings of raw fruits and vegetables each day?
10. How would you describe your current level of satisfaction with your life in general?
11. How would you rate the amount of sleep you get?
12. How would you rate your energy level?
13. How would you rate your success at drinking half of your body weight in ounces of water each day?
14. How would you rate your level of concern over your family health history?
15. How do you usually feel when you first wake up and think about the day ahead?
16. How do you feel about choosing healthy food at restaurants and while on the go?
Please answer yes or no to the following questions:
17. Are you currently being treated for any physical or emotional condition? If so, for what condition(s) are you being treated?
18. Do you currently smoke?
19. Do you have a clear vision of your ideal health?
20. Do you have key relationships that would support you in changing your health?
21. Do you have a computer and enjoy using the Internet?
Please comment below in response to these questions:
22. Do you suspect that you may have an undiagnosed physical condition or emotional disorder which might require treatment?
23. Is there anything I haven’t asked but you would like to tell me?
Thank you, we look forward to evaluating your responses and sending you the results of your evaluation and coaching options that would support you in your health goals.