How Healthy Are You?
CHALLENGES
What are your challenges to losing weight?
Stress
Lack of Exercise
Motivation
Eating too much
Eating wrong foods
Lack of time
COMMITMENT
How committed are you to reach your target weight?
Very committed
Fairly committed
Not committed
How Healthy Are You?
ALCOHOL INTAKE
Do you drink alcohol?
Most days
Occasionally
Rarely/never
EXERCISE – DAILY
How much exercise do you do?
Rarely
Moderate
Regular
How Healthy Are You?
nutrition
Do you take any supplements?
YES
NO
FOOD
Which do you prefer?
VEGAN DIET
VEGETARIAN DIET
NON - VEGETARIAN DIET
OTHER
VEGAN DIET
VEGETARIAN DIET
NON - VEGETARIAN DIET
OTHER
How Healthy Are You?
ALLERGIES
Do you have any allergies to any food?
YES
NO
