Habits and Accountability Questionnaire

Full Name *

Email *

Age *

Please list the main tasks and/or habits you would like us to work on? *

e.g. daily walks, meal prep or motivation to train a certain amount per week (please be specific, so I can begin to plan these habits)

What is the overall goal you would like to achieve over the next 4-8 weeks? *

e.g. being consistent with my training and nutrition or simply making sure to not quit on myself...

Whats the main obstacles stopping you from achieving these? *

e.g. making little progress on your own, lack of motivation...

What is your current occupation and what does it involve on a day to day basis?

So we can begin to narrow down how to balance your tasks around your lifestyle better

Is there anything else you think I'd need to know?

No matter how big or small, feel free to let me know any worries you have.

How did you hear about my services? *

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