Coaching Evaluation Forms

The following questionnaires will help to identify your health goals and bodily imbalances. We then will create a customized protocol that will best benefit your needs.

Health Goals

The following questionnaire will help to identify your health goals and bodily imbalances. We then will create a customized protocol that will best benefit your needs.

8%

Acne, Blemishes & Hormonal Body Fat

When answering each question, choose the option that applies most to you.

Estrogen Dominance

Insulin and Adrenals

Cortisol

Growth Factor, HGH, Peptides

DHEA

Cortisol

Nitric Oxide / Circulation Molecule

Diet and Lifestyle

Body Shape

Emotional Health

Love Life

Body Shape

Goals are the stepping stones to achieving my dreams, consistent with my values. The most important goals must align with my values so they are in harmony and consistent with my values and beliefs: Do those activities that bring me closer to my dreams. Specific Business Goals and Career outcomes. Goals relate to outcomes that are SMART. Specific, ask with who, what, where, when, how. Measureable and meaningful to me, stated in the present tense as if now. Achievable. Improve All areas of my life. Realistic time frame, all is possible. If I always achieve the goal, make it bigger. Responsible, ecology. Timed, when will it occur? Toward what I want. Goals are stated in the positive “I want to be Slimmer”, as opposed to “don’t want to be fat”. Convert a state or emotion to an action behavior with movement.

Dreams - Are the destination I want to reach. The following are my dreams if there were no limits on time, money, or support. Some dreams will be so important they will translate into specific goals, measurable, how much, what it will look like, how I will feel, time frame to complete.

PLEASE READ BELOW AND ADD TO THE DEFINITIONS OF EACH, AND PLEASE PUT THEM IN ORDER OF MOST IMPORTANT, DOWN TO LEAST CHALLENGING FOR YOU! LET YOUR MIND AND PEN OR TYPEWRITTER FLOW, BECAUSE YOU INITIAL UNFLILTERED WORDS ARE LIKELY RIGHT FOR YOU.

Avoid Immobilizing feelings, thoughts, & behaviors to eliminate: These negative emotions are the feeling you would do almost anything to avoid having to feel. By eliminating them I will be free to enjoy life more:

If I ever experience any of these negative feelings, I have to change my state by asking the questions: Who loves me? Who do I love? What makes my happy?

Reframes OF NEGATIVE TO POSITIVE OUTLOOK & BEHAVIOR-TIME LINE Put in your own positive words, and use the sample to guide you