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Find Yourself Healthy - Transform Yourself

Transform Yourself Questionnaire to Find Yourself Healthy

1. Your Contact Information

2. What are your goals and do you have a deadline to reach it: (such as # of pounds to gain or lose, inches to gain or lose, lose a dress size,etc.)

3. What is your Current Weight and Height? And what is your Goal Weight (Build Muscle, Weight Loss, Etc.) ?

4. Describe your Current Lifestyle? (Job, Activities, Family, Time, Stress, Etc.)

5. Have you been Diagnosed with any Health Issues and on any Medication? Or have any Health Concerns (Joint Pain, Etc.)

6. What type of Exercises do you Enjoy and Dislike?

7. Describe your Current Meals and Nutrition (How many meals a day, what type of food, snacks, how much water, soda, what do you crave, etc)

8. Rate Your Energy Level (1 Low - 10High), Do you feel fatigue at all, if so what time of the day?

9. Do you move waste daily?

YesNo


YesNoMaybe

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