Coaching Questionnaire

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Congrats on the first step to reaching your health goals!

Coaching Kickstart

The first step toward your personalized wellness plan

Current Habits

How active are you currently?

Not consistently active

1–2x/week

3–4x/week

5+x/week

What type of exercise do you usually do?

Strength training

Cardio

Pilates

Walking

None, I'm just starting

How would you describe your current nutrition habits?

I eat what’s convenient

I try to eat healthy but struggle with consistency

I track macros or calories

I eat intuitively

How many hours of sleep do you usually get per night?

<5 hours

5–6 hours

7–8 hours

9+ hours

Fitness

What is your main fitness goal?

Build strength / muscle

Lose fat / tone

Improve endurance / stamina

Increase mobility / flexibility

General health & wellness

What’s your biggest challenge when it comes to fitness?

Motivation / consistency

Lack of time

Not knowing what exercises to do

Injuries or physical limitations

Sticking to a plan

Do you have access to a gym or prefer home workouts?

Gym

Home

Mix of both

Nutrition

What is your main nutrition goal?

Eat healthier / more balanced

Lose weight

Gain weight / build muscle

Improve gut health / digestion

Reduce stress-related eating

What’s your biggest struggle with nutrition?

Knowing what to eat

Meal prep / time

Cravings / emotional eating

Sticking to a plan

Mindset

How would you describe your stress level?

Low

Moderate

High

Overwhelming

What activities do you do to improve your mental health?

Meditation

Journaling

Yoga

Other

On a scale of 1-10 how would you rate your mental health?

Schedule

What time of day do you usually have the most energy?

Morning before work/school

Midday / lunch break

After work / school

Evenings

It varies — depends on the day

How many days per week would you like to work out?

1-2

3-4

How much time can you realistically dedicate to workouts?

15–20 minutes

30–45 minutes

1 hour

>1 hour

How much guidance do you prefer?

Step-by-step plan / very structured

General guidance with flexibility

Just support & accountability

Basic Info

Age Range

<18

18-22

23-29

30-39

40+

First Name

Last Name

Email Address