WEIGHT, HEALTH, AND LIFESTYLE QUESTIONNAIRE
Thank you for taking the time to fill in as much, or as little, of this information as you desire. This will help me form a preliminary weight loss assessment prior to our first meeting which will save time during our valued time together and gives both an idea of what to expect from each other during our time together.
This questionnaire is a basic assessment of two things which are critical to your development. How you eat today vs. how you would like to eat today. What would you like most out of our time together?
Each of these questions has been carefully curated based on my own history of binge eating, weight loss, mental health and false dietary assumptions.
This information will be kept private, will not be shared with anyone other than myself and will be deleted upon your request.