New client form

BELIEVE IN THE POSSIBILITY

Hey, so this is where things all start to change and it is time to get excited!!!!!! below is a few questions so we can really get the absolute best out of this whole experience for you, so fill it out as fully and honestly as possible, the deeper and more honest you are the better. It is really crucial that you are honest as possible, remember this is all about you and getting the best for you and i am really looking forward to helping you achieve your goals.

Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of birth

Day
Month
Year
Email
Why is this important to me? And how to make sure I get it!!! 1. If we were having a discussion twelve months from today, and we were looking back over the previous twelve months, what HAS to have happened in your life for you to be HAPPY with your progress? What EXACTLY is it you REALLY want?
What is it you really want? I want you to let your imagination run wild here. Don't worry about if you think you can do it or not or anything else. Just put down what would be your dream scenario
Why is this important to me? (emotional reasons) Why MUST it happen? What is your core motivation. what is going to keep you going and really drive you on? Once again go deep here, keep digging down for the reasons why… if you say ‘so I feel better’ then you need to think ‘why do I need to feel better?’ and keep digging down like that all the way down the rabbit hole. Pull up as many reasons as you can.
What do I need to do to pull it off? What in your opinion do you need to do to achieve it? List everything you can think of get specific.
Am I prepared to do it? (be honest)
What area or circumstance in your life do you struggle with the most? what is your one biggest obstacle?
Finish this ssentance. I can't get leaner because......
7. Write out a few excuses you might be clinging to (nothing ever works, i don't have time, i don't know what to do, i don't have the body type, i don't know about food) whatever they are write them out. What is the story you tell yourself about why you can't do it?
8. Write out a few seemingly inconsequential small steps you can take every day that can move you closer to achieving your goal.
9. Identify your three best habits - those that will support your goal
10. Identify your three worst habits - those that will move you away from your goal
10. Identify three new habits you need to develop that will put you on track to achieving your goal.
11. List three areas where you need to be more consistent
12. What would you like the most help with?
13. What i don't want to feel. Here you write down a list of feelings/emotions you currently have that you do not want to feel anymore. ie i don't want to be sad, i dont want to feel fat. Whatever they are, write them down, they can be related to anything.
14. What i do want to feel. similar to above but here you are writing down the ones you do want to feel how would you like to feel
15. Write out a list of the things that come to mind when you say the words 'I AM' this can be anything good or bad just put them down. Really think about this one and put down as many as you can think of
16. How will you feel 6 months from now if you have achieved your goal?
17. HOW WWILL YOU FEEL 6 MONTHS FROM NOW IF YOU HAVE NOT ACHIEVED YOUR GOAL?
19. What are your favourite foods?
20. What foods don't you like?
What are the foods that you think will be the hardest for you to give up?
What foods do you not want to have to give up?
Why?
21. What are your food weaknesses? what is your go to foods?
22. Would you say you are an emotional eater?
do you do a weekly shop?
do you cook?
how easy will it be to implement change in your view?
how ready and willing are you to change habits and behaviours?
how open are you to new ideas and suggestions?
what are the benefits of changing?
what would be BAD about changing? really think about this. DO NOT just say nothing, there is always something. otherwise you would of done it already.
What do you think will be the hardest things for you to change?
What behaviours and activities do you not want to give up?
what do you think when you think about changing? good and bad
are your periods regular?
are you on any medication?
how often do you drink?
what have you tried in the past?
what is your support like?
who in your life is most supportive?
who in your life is least supportive?
list one thing you could do to improve your support?
what is it you think you need? what are you looking for? i am talking about feelings and emotions here. what will changing do for you emotionally?
why is achieving your goals an absolute must?
what are your 3 biggest struggles?
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MAKE IT HAPPEN