MEMBER CHECK IN

Taking into account your life and habits over the past month, read the following statements and rate yourself in each area on a scale from 1-5, 1 representing “disagree/need support or improvement” and 5 representing “agree/doing great.” After rating yourself in each area, please provide additional feedback, especially if you rated yourself with a low number. Please note: This information is handled through our secure website and with the utmost confidentiality.

    Your name (required)


     

    SLEEP

    I am consistently getting a minimum of 7 hours of sleep per night and my sleep quality is good. I wake up rested most of the time.

    Please explain why you rated yourself as you did.


     

    STRESS LEVEL

    My overall stress level is manageable and not overwhelming. I am able to cope with stress and anxiety effectively, and feel restored regularly. My key roles and relationships in life, as well as my mental health, are functioning well the majority of the time.

    Please explain why you rated yourself as you did.


     

    NUTRTION

    I am consistently eating/drinking to support my health and goals, including getting adequate hydration and a variety of fresh, whole foods, like fruits, veggies, whole grains, lean proteins, etc. I feel good about my nutrition habits and choices the majority of the time.

    Please explain why you rated yourself as you did.


     

    EXERCISE & ACTIVITY OUTSIDE OF PERSONAL TRAINING

    I am consistently active throughout my week outside of my scheduled personal training sessions. I walk, stay active, or exercise independently a minimum of 2-3 additional days beyond my training sessions.

    Please explain why you rated yourself as you did.


     

    PERSONAL TRAINING

    I am consistently attending and enjoying my personal training sessions, feeling appropriately challenged, and making progress toward my fitness goals. I feel successful and supported in my training.

    Please explain why you rated yourself as you did.


     

    ADDITIONAL COMMENTS

    Any other feedback, questions, or thoughts pertaining to this survey or how your trainer can better support you?