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CORPORATE PERFORMANCE
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50
Questions
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1
Full name
First Name
Last Name
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Age:
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3
Height:
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Date of Birth:
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Date
Month
Day
Year
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Email:
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Mobile Phone:
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Current Weight:
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8
Would you like your weight to be different? If so how?
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Large
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quote
Created with Sketch.
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9
What are your top health goals?
Energy
Weight Loss
Toning
Sleep / Waking up
Digestion
Mood / Confidence / Anxiety
Positivity
Stress
Pain relief /sore joints / chronic fatigue
Fat loss
Other
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10
Are these struggles affecting your quality of life
YES
NO
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11
How many hours do you work per week?
1-8 hours
9-16 hours
17-24 hours
25-32 hours
33- 40 hours
40+ hours
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12
Stress Ranking: I ___________ feel stressed
Never
Rarely
Sometimes
Often
Always
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13
What are your main stressors in life?
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How do you feel stress impacts your health?
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15
How do you manage stress? Do you have a crutch?
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16
Any serious illnesses/hospitalisations/injuries?
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17
When was last time your took antibiotics? Did you take them chronically when young?
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18
How is/was the health of your mother?
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19
How is/was the health of your father?
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20
What is your ancestry?
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21
What is your blood type?
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22
Any history of family illness eg cancer, heart disease, diabetes, prostate?
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23
How is your sleep? How many hours of sleep per night
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24
Do you wake up during the night? If so, why?
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25
Do you experience any of the following more than once a week? (Can choose more than one)
Cramps
Constipation
Diarrhoea
Gas
Insomnia
Sore Joints
Headaches
Bloating
Heart Palpitations
Dizziness
Low Energy
Water retention
Constipation/Diarrhoea/Gas?
IBS
Other
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26
Do you eat sat down or on the go? Or whilst distracted, eg phone, work, TV
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27
Allergies or sensitivities? Please explain:
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28
LADIES Are your periods regular?
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29
LADIES Painful or symptomatic? Please explain:
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30
Do you experience yeast infections or urinary tract infections?
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31
Do you take any supplements or medications? Please list:
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32
What percentage of your food is home-cooked?
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33
Do you use cleaning products?
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34
How much water do you drink per day?
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35
Do you drink sweetened beverages eg juice, soda, wine?
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36
Do you drink alcohol?
Yes
No
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37
Do you eat processed or premade foods?
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38
When is your last meal before bed
1 hour or less
3 hours or more
2 hours
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39
Do you crave sugar, coffee, alcohol or cigarettes? Do you have any other major cravings or addictions?
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40
Do you use traditional beauty products on your skin?
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41
DAY 1 Food Journal
*
This field is required.
TIME
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
FOOD / SNACK / DRINK / SUPPLEMENT
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
WAKE UP<br>
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
BREAKFAST<br>
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
SNACK
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
LUNCH
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
DINNER
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
EXERCISE
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
WATER (L)
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
COFFEE<br><br>
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Row 7, Column 3
SUGARED BEVERAGES
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Row 8, Column 3
WAKE UP<br>
BREAKFAST<br>
SNACK
LUNCH
DINNER
EXERCISE
WATER (L)
COFFEE<br><br>
SUGARED BEVERAGES
TIME
Row 0, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 0, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 0, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 0, Column 3
TIME
Row 1, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 1, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 1, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 1, Column 3
TIME
Row 2, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 2, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 2, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 2, Column 3
TIME
Row 3, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 3, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 3, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 3, Column 3
TIME
Row 4, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 4, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 4, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 4, Column 3
TIME
Row 5, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 5, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 5, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 5, Column 3
TIME
Row 6, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 6, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 6, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 6, Column 3
TIME
Row 7, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 7, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 7, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 7, Column 3
TIME
Row 8, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 8, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 8, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 8, Column 3
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42
DAY 2 Food Journal
*
This field is required.
TIME
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
FOOD / SNACK / DRINK / SUPPLEMENT
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
WAKE UP<br>
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
BREAKFAST<br>
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
SNACK
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
LUNCH
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
DINNER
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
EXERCISE
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
WATER (L)
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
COFFEE<br><br>
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Row 7, Column 3
SUGARED BEVERAGES
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Row 8, Column 3
WAKE UP<br>
BREAKFAST<br>
SNACK
LUNCH
DINNER
EXERCISE
WATER (L)
COFFEE<br><br>
SUGARED BEVERAGES
TIME
Row 0, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 0, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 0, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 0, Column 3
TIME
Row 1, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 1, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 1, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 1, Column 3
TIME
Row 2, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 2, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 2, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 2, Column 3
TIME
Row 3, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 3, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 3, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 3, Column 3
TIME
Row 4, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 4, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 4, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 4, Column 3
TIME
Row 5, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 5, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 5, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 5, Column 3
TIME
Row 6, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 6, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 6, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 6, Column 3
TIME
Row 7, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 7, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 7, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 7, Column 3
TIME
Row 8, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 8, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 8, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 8, Column 3
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DAY 3 Food Journal
TIME
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
FOOD / SNACK / DRINK / SUPPLEMENT
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
WAKE UP<br>
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
BREAKFAST<br>
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
SNACK
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
LUNCH
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
DINNER
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
EXERCISE
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
WATER (L)
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
COFFEE<br><br>
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Row 7, Column 3
SUGARED BEVERAGES
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Row 8, Column 3
WAKE UP<br>
BREAKFAST<br>
SNACK
LUNCH
DINNER
EXERCISE
WATER (L)
COFFEE<br><br>
SUGARED BEVERAGES
TIME
Row 0, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 0, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 0, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 0, Column 3
TIME
Row 1, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 1, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 1, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 1, Column 3
TIME
Row 2, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 2, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 2, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 2, Column 3
TIME
Row 3, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 3, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 3, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 3, Column 3
TIME
Row 4, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 4, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 4, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 4, Column 3
TIME
Row 5, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 5, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 5, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 5, Column 3
TIME
Row 6, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 6, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 6, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 6, Column 3
TIME
Row 7, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 7, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 7, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 7, Column 3
TIME
Row 8, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 8, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 8, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 8, Column 3
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DAY 4 Food Journal
TIME
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
FOOD / SNACK / DRINK / SUPPLEMENT
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
WAKE UP<br>
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
BREAKFAST<br>
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
SNACK
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
LUNCH
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
DINNER
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
EXERCISE
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
WATER (L)
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
COFFEE<br><br>
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Row 7, Column 3
SUGARED BEVERAGES
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Row 8, Column 3
WAKE UP<br>
BREAKFAST<br>
SNACK
LUNCH
DINNER
EXERCISE
WATER (L)
COFFEE<br><br>
SUGARED BEVERAGES
TIME
Row 0, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 0, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 0, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 0, Column 3
TIME
Row 1, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 1, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 1, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 1, Column 3
TIME
Row 2, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 2, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 2, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 2, Column 3
TIME
Row 3, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 3, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 3, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 3, Column 3
TIME
Row 4, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 4, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 4, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 4, Column 3
TIME
Row 5, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 5, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 5, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 5, Column 3
TIME
Row 6, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 6, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 6, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 6, Column 3
TIME
Row 7, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 7, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 7, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 7, Column 3
TIME
Row 8, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 8, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 8, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 8, Column 3
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DAY 5 Food Journal
TIME
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
FOOD / SNACK / DRINK / SUPPLEMENT
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
WAKE UP<br>
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
BREAKFAST<br>
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
SNACK
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
LUNCH
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
DINNER
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
EXERCISE
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
WATER (L)
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
COFFEE<br><br>
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Row 7, Column 3
SUGARED BEVERAGES
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Row 8, Column 3
WAKE UP<br>
BREAKFAST<br>
SNACK
LUNCH
DINNER
EXERCISE
WATER (L)
COFFEE<br><br>
SUGARED BEVERAGES
TIME
Row 0, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 0, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 0, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 0, Column 3
TIME
Row 1, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 1, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 1, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 1, Column 3
TIME
Row 2, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 2, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 2, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 2, Column 3
TIME
Row 3, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 3, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 3, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 3, Column 3
TIME
Row 4, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 4, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 4, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 4, Column 3
TIME
Row 5, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 5, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 5, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 5, Column 3
TIME
Row 6, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 6, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 6, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 6, Column 3
TIME
Row 7, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 7, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 7, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 7, Column 3
TIME
Row 8, Column 0
BEFORE FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 8, Column 1
FOOD / SNACK / DRINK / SUPPLEMENT
Row 8, Column 2
AFTER FOOD Mood, Pain, Energy, Headaches, Sinus, Bloating
Row 8, Column 3
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Is there anything else you would like to share?
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Is there anything else you feel I should be aware of that might help me help you to create the best personalised lifestyle plan
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Do you have any blood results or other medical assessments pls upload here
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Book Your Private 1 on 1 Call to create your personalised plan!
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Contract | Coaching Agreement Terms & Conditions
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At Sabina Sulovsky Coaching I am honoured to serve you through this powerful and effective coaching program. I know with your commitment, this will truly be a life changing experience for you! By signing below, you are agreeing to comply with and be bound by the following terms of use. Please review the following terms carefully. The term Sabina Sulovsky Coaching or “us” or “we” or “our” refers to Sabina Sulovsky Coaching. The term “you” refers to the client/student of the coaching program.
Restrictions and Prohibitions on Use
As part of gaining your desired results from the program, We may collect the following kinds of personal information: ● contact details such as your name, date of birth, address, email and telephone number; ● your personal information such details about your personal life experiences, etc ● information about your experience with Sabina Sulovsky Coaching, including your use of our services; Sabina Sulovsky Coaching may also collect sensitive information about you (for example information about your health or any disability). However, we only do so with your consent and/or as authorised by law.
How we Protect Personal Information
Sabina Sulovsky Coaching, stores personal information in both hard copy and/or electronic form. Sabina Sulovsky Coaching, is committed to maintaining the safety and security of your personal information and has measures in place so that this can be achieved.
These measures include:
● ensuring that personal information stored in hard copy form where necessary and is kept under locked security whenever practicable; and ● ensuring that personal information stored in electronic form is password protected whenever practicable.
How we use Personal Information
Sabina Sulovsky Coaching, will only use your personal information as permitted by law. This means that we will only use your personal information for the purpose for which it was collected (such as those referred to above) or for a purpose related, or in the case of sensitive information directly related to that purpose. Sabina Sulovsky Coaching, does not disclose personal information to any overseas recipients. Sabina Sulovsky Coaching, does not use any Government related identifiers (such as your driver licence number) as our own identifier for you.
Client and Coach Responsibilities:
1. Coach agrees to maintain integrity and morals that best serve the Client. 2. Client is responsible for creating and implementing his/her own physical, mental and emotional well-being, decisions, choices, actions and results. As such, the Client agrees that the Coach is not and will not be liable for any actions or inaction, or for any direct or indirect result of any services provided by the Coach. Client understands coaching is not therapy and does not substitute for therapy if needed, and does not prevent, cure, or treat any mental disorder or medical disease. 3. Client understands that coaching is a complementary approach and not to be used as a substitute for professional advice by legal, mental, medical or other qualified professionals and will seek independent professional guidance for such matters. If Client is currently under the care of a mental health professional, Coach will recommend that Client inform the mental health care provider and the client may need to have a referral letter from their health care provider. 4. Client agrees to communicate honestly, be open to feedback and assistance and create the time and energy to participate fully in the Services provided. 5. For Group Coaching, Sabina Sulovsky Coaching, agrees that it is the Client’s responsibility to notify the Coach at least 24 hours in advance of the scheduled call/meeting if the Client cannot make the session. Client will be billed for a missed session if the Client does not turn up/attend the session. Coach will wait for 15 minutes, before the Client is noted as not turning up for the session.
Termination:
Either the Client or the Coach may terminate this agreement at any time with written notice. In this case the Transfer and Cancellation section of this agreement will dictate the financial obligations of each party.
Fees & Services:
All fees are as noted at the time of purchase at the Coaches discretion and may vary from one Client to another Client. The time/location/method of the coaching sessions will be determined by Coach and Client based on a mutually agreed upon time/location/method.
Transfer & Cancellation Policy
I, the client (as signed below) understand that I have three days to cancel this agreement and have 100% of my investment refunded. Thereafter, I understand there are no refunds given after the 3 days from the date of the signed enrolment agreement. I understand if I am on a payment plan, I am liable to honour the payments of the payment plan for which I have agreed to. I understand the fee I have paid and the total fee for the course is not transferable to another course or program. I understand if for whatever reason I have to stop the program within the payment term that I am liable to honour the repayment plan to which I have agreed to. I understand if I am on a payment plan, there is a $20 fee if there is a dishonoured transaction. I agree to honour my repayments to the third party organisation should we use one. We are excited to serve you on your journey and look forward to an outstanding course. Sabina Sulovsky
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