Readiness Questionnaire

Name(Required)
Do you feel motivated to lose excess body weight/fat at this time?(Required)
How motivated are you to change you eating habits at this time?(Required)
How motivated are you to increase your physical activity at this time?(Required)
How motivated are you to try new strategies/techniques for changing your health behaviors at this time?(Required)
The Well-Being Program will teach you the tools for long term success. Some of these include tracking your daily food intake and physical activity, taking time to meal prep, building a sleep routine. How confident are you that you can devote daily time and effort to these activities?(Required)
How confident are you that you will be able to record everything you eat and drink and your movement, most days of the week for 10-12 weeks?(Required)
How satisfied would you be if you achieved a 5%-10% weight loss that significantly improved your wellness and overall quality of life?(Required)