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Coaching Assessment
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Name
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First Name
Last Name
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Email
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example@example.com
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3
Main goal you want to achieve while working with me
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4
How active are you?
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1 = sedentary, no activity
10 = very active
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5
Briefly describe your current activity
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Frequency of activity, type, current routine (if any)
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6
How would you rate your nutrition knowledge?
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1 = very little
10 = very confident
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7
What does a typical day of eating look like for you?
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Please list everything you ate and drank today or yesterday
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8
What has stopped you from making progress in the past?
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(Time, consistency, motivation, knowledge, stress, other)
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9
How consistent do you feel you can realistically be right now?
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1 = not very
10 = very consistent
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10
Select what you’re looking for from coaching.
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Guidance & Education
Structure & Guidance
Accountability & Consistency
Performance Optimization
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11
Is there anything else you think I should know before our call?
(Injuries, schedule constraints, stress, past experiences, etc.)
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