At the end of this audit you will have the opportunity to book a free 1:1 call with me to review your results.
Name
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First Name
Last Name
Email
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example@example.com
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What symptoms are you dealing with on a regular basis? Check all that apply
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Gut symptoms (i.e. bloating, constipation or diarrhea)
Brain fog (i.e. trouble remembering/thinking clearly, difficulty shifting tasks)
Poor moods (i.e. anxiety, depression, irritibility, anger outbursts, stress, mood swings)
Low energy (i.e. chronic fatigue, after meals, or around 2pm daily)
Skin manifestations (i.e. acne, psoriasis, eczema, etc)
Hair loss or thinning hair
Dark circles under eyes
Weight gain or difficulty losing weight
Easily cold, especially in the hands and feet
Sweat quite a lot and very easily
Bad breath or body odor
Sick relatively often, or infectious outbreaks relatively often
Irregular periods (i.e. cycle very long or very short or sporadic in length)
Problems with sleep (i.e. trouble falling/staying asleep or not getting adequate sleep)
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How often do you consume meat?
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I only eat meat/carnivore
I eat meat every day
I eat meat most days of the week
I eat limited meat like fish or chicken on most days, but NO red meat
I am vegetarian
I am vegan
How often are you consuming plants like fruits, veggies, and legumes on most days?
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I eat 2-3 servings of plants with each meal daily and/or as snacks (6-9 servings daily)
I eat at least 1 serving of plants w/ each meal daily + some snacks (3-6 servings daily)
I eat 1 serving of a plant per day, but not more than 3 servings daily
I do not eat fruit on most days
I do not eat greens on most days
I do not eat beans or other legumes on most days
How often are you consuming foods with highly processed grains like bread/toast, cereal, croissants, pasta, crackers, pastries, pies, pop tarts, toaster strudels, croutons, pancakes, cakes, etc?
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I eat processed grains with every meal and also usually with at least 1 snack too
About 1-2 times per day
About once every 2-3 days
I don't really eat processed grains most days, but then I will eat quite a lot of them on weekends or scheduled cheat days
I do not eat processed grains on most days
How often do you consume fish/seafood?
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Daily
2-3 weekly
Once a week
About 1-2 times per month
I do not consume fish or seafoods regularly
If you were to give yourself a grade on how well you are nourishing your body, what grade would you give yourself?
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A+ Perfect
A Almost perfect
B Better than average
C Average
D Not quite as good as average
F I know I am failing to nourish my body
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On a normal week, what types of physical activity do you partake in regularly for at least 20 minutes at a time?
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Walking inside or outside
Weight lifting
Yoga, pilates or something similar
Cycling or riding a bicycle of sorts
Crossfit, F45 or other high intensity classes
Dance classes (i.e. jazz, ballet, Zumba, hip-hop, ballroom, etc)
Swimming
Sex
Other
If you were to give yourself a grade on how well you are taking care of your physical body through movement, what grade would you give yourself?
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A+ I am or train like a top athlete who is staying nourished and hydrated, very fit and honoring my body's recovery time.
A I am very fit and in-shape cardiovascularly as well. Or I regularly get 12K+ steps/day.
B Better than average, I get 150-300 min of weekly exercise
C Average 75-150 min of physical activity weekly
D Less than average
F I am failing to take care of my body
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If you were to give yourself a grade on how well you are taking care of your sleep, what would you grade yourself?
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A+ I prioritize sleep and make sure to get 8 hours every night. I sleep through the night like a champ and feel well-rested in the morning.
A I get 8 hours of sleep most nights.
B Better than average (7-8 hours).
C Average is ~7 hours.
D Around 6 hours nightly.
F Unfortunately, usually 5 hours or less.
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If you were to give yourself a grade on how well you are managing stress, what would you grade yourself?
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A+ I give myself time (60 min+) each day to focus on my needs and wants and feel that I know the techniques that work for me to manage my stress. I am very reflective and keep an open mind to new ideas and techniques to further grow.
A I give myself (60 min+) most days to focus on my needs/wants and I generally know which techniques work for me.
B Better than average. I know what my triggers are and have a few techniques I do to help me manage them. These tools are somewhat helpful, but I know there is room for improvement.
C I want to improve in this department, but I am not sure where to start. I tried some of the stress-managing tools before (i.e. meditation, therapy, breathwork, etc), but I do not feel like they helped.
D I know a few of my big triggers and when they happen, I feel emotionally unstable and sometimes even explosive. It takes a quite a long time for me to calm down.
F I tend to distract myself from any possible trigger. I drown out the noise somehow (i.e. by always being connected to my smartphone/device or TV, by drinking alcohol, smoking marijuana or taking other substances regularly to numb out, by being a work-a-holic, by eating too much, or by some other method to distract myself from dealing with my problems).
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I will tally up your points based on your quiz answers and you'll be assigned one of 3 categories: Foundation, Progression or Optimization. Which category do you think you currently fit into?
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