Name

First Name

Last Name

Being healthy is a choice. The part I currently struggle the most with is:

Exercise is easier to do when you enjoy it. What type of workouts do you enjoy most, and what are you hoping to get out of your workouts?

In order to make 2017 my best year yet ...I need and want to learn more strategies on:

Workout ideas.

Food Recipes.

Healthy Boundaries with Family and Friends.

Setting / Achieving Goals.

Weekly Planning.

Strategies to Control Stress / Anxiety.

Making time for Myself.

Self Esteem and Self Discipline are important life factors. Would you say you have healthy self esteem / discipline. Why or Why Not.

How many meals do you eat out each week?

What is your favorite (most often consumed beverage)? Top 3.

On average how many hours a week do you take time out for something you enjoy? Explain a few activities "YOU" enjoy and build into your calendar each week.