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PERSONAL AND SMALL GROUP TRAINING
NUTRITION COACHING
- 3 month Nutrition Coaching Questionnaire
ABOUT ME
YOGA

HOME
PERSONAL AND SMALL GROUP TRAINING
NUTRITION COACHING
- 3 month Nutrition Coaching Questionnaire
ABOUT ME
YOGA

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YOUR CART

* Indicates required field

Client Name: *

Weight please? *

Chest Measurement (inches) - measure at nipple level *

Waist Measurement (inches) - measure 1 inch above navel *

Hip Measurement (inches) - measure at the fullest part of your butt *

How was your mood this last week? *

So much joy Mostly good Meh Glass half empty

Let me elaborate... *

How were your energy levels? *

Productivity was my middle name Mostly active but needed some down time Some highs, some lows Low energy most days

What were stress levels like? *

No stressors this week Some stress, but manageable Stressed more than not Struggle bus

Here's why: *

How was your hunger level? *

I had trouble getting all of my food down. No hunger. I was hungry a couple times. I felt very hungry most days.

How was sleep? *

Slept through most nights and felt rested! Pretty good. Had trouble falling asleep or staying asleep. I could hardly sleep at all.

How closely did you follow your template this last week? (Please be honest.) *

100% 90/10 80/20 70/30 60/40 50/50 or worse

I chose 70/30 or below, and here's what happened: *

I want to tell you more about my week to help you guide me as we move forward: *

Submit

SHAKTI FIT

shaktifit@yahoo.com
419-957-1997
20495 Arrington Road Utica, Ohio

YOGA. TRAINING. NUTRITION.

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