PN Initial Assessment – Part 1

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Tell me more about yourself.

By learning more about your lifestyle and your habits, I can take  better care of you and make sure coaching is a good fit for your goals and individual needs.

Staying in touch

What do you want?

What do you expect?

What do you want to change?

PN Initial Assessment – Part 2

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Before you start filling out Part 2 please SUBMIT part 1. Thanks!

What’s around you?

What’s your health like?

How are you spending your time?

In an average week, how many hours do you spend...

How is your stress and recovery?

Think about all the activities you’re involved in (e.g., work, school, caregiving, housework, travel). Then assess as best you can:

How ready, willing, and able are you to change?

Right now, on a scale of 1-10:


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.