Fitness Reflection Questionnaire Form

Fitness Reflection Quesionnaire

If you are working to make improvements in your Fitness, Nutrition, and Health I am here to help. Sometimes we just need a quick tip or trick to set us on the right path, other times we need a road map to reach our destination. This reflection is to help find where you are, where you want to be, what you are doing to get there, and if you need any help along the way.

Personal Information

First Name

Last Name

Phone Number

Reflect on you relationship with Fintess

What does Fitness mean to you?

How important is Fitness to you of a scale of 1-10?

Tell me about your current Fitness level.

Reflect on you relationship with Nutrition

What does Nutrition mean to you?

How important is Nutrition to you on a scale of 1-10?

How do you feel about your Nutrition right now?

Reflect on you relationship with Health

What does Health mean to you?

How important is Health to you on a scale of 1-10?

Tell me about your Health condition past and present.

Looking Back At Your Answers

Based on your answers, is there one or more areas that you could improve? If so, what are they?

Are you currently taking steps to improve these areas? If so, what are they? (if you feel comfortable sharing)

Could you use help improving one or more of these areas?

Yes

Are you open to having a conversation with me to review your answers?

Yes

If you could use some help with Fitness, Nutrition, or Health and are open to having a conversation about your answers, I will reach out to you very soon.

I will be in touch soon!