Nutrition Coaching Weekly Check-In
Each week you will upload your weight, your measurements and progress photos into the app. We also would like you to answer the following questions
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
1. How was your energy this week?
1
2
3
4
5
6
7
8
9
10
No Energy
Extremely Energized
1 is No Energy, 10 is Extremely Energized
2. How was your sleep this week?
1
2
3
4
5
6
7
8
9
10
Barley Slept
Got 8 Hours per Night!
1 is Barley Slept, 10 is Got 8 Hours per Night!
3. Use the Hunger-Fullness Scale to identify how you feel when you are 100% compliant with your meal plan.
At 1, starving or dizzy
At 2, very hungry, low energy
At 3, pretty hungry stomach beginning to growl
At 4, beginning to feel hungry
At 5, satisfied, neither full or hungry
At 6, pleasantly full
At 7, slightly uncomfortable
At 8, feeling stuffed
At 9, very uncomfortable
At 10, so full, sick to stomach
4. Have your stress levels increased or decreased this week?
Increased
Decreased
5. How was your water intake this week?
1
2
3
4
5
6
7
8
9
10
Barley Drank
Drank a gallon Each Day!
1 is Barley Drank, 10 is Drank a gallon Each Day!
6. Would you like any changes to be made on your meal plan?
7. Is there anything else we could be doing to help you through this process?
8. Do you have any questions, comments or concerns?
9. Would you like to schedule a 20 min. complementary Nutrition phone call this upcoming week?
Yes, please!
No, I got this!
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