PRECISION NUTRITION / FITNESS

Welcome to Nutrition & Body Transformation Coaching at FITNESS! Please complete the form below to get started. Your coach, Andrea, will be in touch shortly to schedule your first call.
If you begin completing this form, but do not have time to finish it, you can scroll to the bottom of the page and click “Save and Continue Later.” An email will be sent to you with a link to your partially completed QUESTIONNAIRE.
  • Tell Me About Yourself

  • Date Format: MM slash DD slash YYYY
  • Staying in Touch

  • What Do You Want?

  • What Do You Expect?

  • What Do You Want to Change?

    1=Horrible / 10=Awesome
  • What’s around you?

    1=Not at all / 10=Completely
  • What's Your Health Like?

    1=Worst / 10=Awesome
  • How Are You Spending Your Time?

    Please indicate the approximate hours spent in a given week on each of the following activities:
    1=MY LIFE IS PANICKED AND INSANE 10=MY LIFE IS PERFECTLY CALM AND RELAXED
  • How Is Your Stress & Recovery?

    Think about all the activities you’re involved in (e.g., work, school, caregiving, housework, travel). Then assess as best you can:
    1=No stress / 10=Extreme stress
  • How ready, willing, and able are you to change?

    Right now, on a scale of 1-10:
    1=Not at all / 10=Completely
    1=Not at all / 10=Completely
    1=Not at all / 10=Completely
  • Please recognize that it is your responsibility to work directly with your health care provider before, during, and after seeking nutrition and / or fitness consultation. Any information provided is not to be followed without prior approval of your doctor. If you choose to use this information without such approval, you agree to accept full responsibility for your decision.