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Is Your Check In Due? Great! Please complete all the fields below!

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Name

First Name

Last Name

Email Address

Body Composition

What were your weigh-ins this week?

Daily weigh-ins aren't required. Once a week is sufficient. Weigh-ins should be first thing in the morning, naked, before eating and after going to the washroom

Saturday (last weekend)

Monday

Wednesday

Friday

Fill out your measurements below

measurements should be taken first thing in the morning, naked, before eating and after going to the washroom

Waist

Hips

Thighs

Chest

Arms

What do you see externally and internally when you look in the mirror? Do you appear leaner, tighter? Stronger? Happier?

Have you received any compliments? Noticed your clothes fitting better? Other positive feedback?

If so, that's great! Tell me more?

Dietary Adherence

How did things go with your diet last week?

On average, how much protein have you been consuming each day?

On average, how many servings of fruit and veggies are you consuming each day?

On average, how much liquid (including everything except alcohol) are you consuming each day?

How many times did you eat out last week?

How much alcohol (if any) did you consume last week?

Habits and Goals

What is your long-term identity-based goal?

Comment below if this has changed from last week

What are 2-3 habits you are currently implementing to achieve your identity-based goal?

On a scale of 0-10 (10 being the best) how well did you do with implementing these habits last week?

What's one thing you can do next week to bring this rating closer to 10?

What's something that you did well the past week that you're proud of and can celebrate?

Biofeedback

Where are you at in your menstrual cycle?

How have your bowel movements been?

On a scale of 1 to 10 (1 being poor and 10 being good), how well have you been sleeping?

Why did you give yourself this rating? What's something you can work on to get more sleep?

On average, how many hours of sleep are you getting each night?

On a scale of 1 to 10 (1 being the lowest an 10 being the highest), what would you rate your stress levels at this past couple of weeks?

What's something you can do this week do reduce that rating?

Final Thoughts

What is a positive quote or affirmation that can help shape your week ahead?

Use this quote to set the tone for your new week ahead

Do you have any questions or concerns? Please feel free to provide any general comments not covered thus far. Any positive or negative feedback is always welcome

Optional