Coaching Check-in Questionnaire Please answer the following questions as best you can. If you need help understanding them you can click the + sign within some of the questions to get more detailed instructions. Your Name Your Email Today's date What was your weekly average weight? + Enter your average weight for the week. If we decided that weighing daily was best then take the average of all 7 days (or the number of days you were able to do). If twice a week is what we talked about then just average the two days together. If once/week, just enter that weigh-in. Leave blank if we decided not weighing was best. What were your tape measurements? + With these take your measurements at the largest part of each area and then consistently measure in that place each time. These are only done once every 2 weeks, so you can skip them this time if you did it last week. Waist Hip Thigh Upload your progress pic + While not required to share with me I still encourage you to take progress pictures once every 4 weeks so you can see progress that's hard to notice day to day when you see yourself all the time. Wear a swimsuit or other clothes you feel comfortable in where you can see changes and take a picture from the front, side, and back. Then if you'd like to share just click the button below and upload a single picture (preferably from the front). Your pictures are kept confidential and will never be shared without your permission. How many steps did you get, on average, per day? + If you have a way to track your daily steps go ahead and enter your average steps into the box below. Most smartphones have the capability to track steps for you by using a free app. With the iPhone the "Health" app does it automatically. What was your biggest non-scale victory (NSV) this week? + For this try to focus on the process and behaviors. This is where transformation occurs. Did you change the way you think about a certain situation? Did you make better choices at a restaurant? Did you eat more mindfully? Did you hit a new personal best with your exercise? Etc. Tell me the problem you worked on solving during your self-sufficiency week using the S.U.P.E.R. Coaching Model + Give me the details of the problem you worked to solve. What was the situation? What was your understanding of that situation? What new perspective did you create? What action did you take to reinforce that perspective? And what was the result? Rate your current progress picture using the questions below 1 = not very, 10 = very How good is your current relationship with food? (if rated 6 or less please explain in box below) + How consistent were you with your eating? How satisfied were you? Do you eat mindfully? Do you practice moderation with a guilt-free mindset? Do you view all foods on a level playing field? Do you label foods "good" or "bad"? Are you always thinking about your next meal? Do you feel restricted or deprived? Do you eat what you want at restaurants? Does food control you? Etc 12345678910 How good is your current relationship with your body? (if rated 6 or less please explain in box below) + Body image has nothing to do with how you look and everything to do with how you see yourself. It is perception - not truth. So it can be changed without a change in appearance. Do you love your body? Does it prevent you from living your full life experience? Do you say things to yourself you wouldn't say to another person? Are you influenced by other people's judgements of you? Do you feel healthy, strong, energetic? Do you accept yourself as-is without contingencies? Etc. 12345678910 How good is your current relationship with exercise? (if rated 6 or less please explain in box below) + Would you choose the exercise you do even if you could never lose another pound? Do you exercise for the sheer joy of it? Or are you doing it for an outcome? Do you associate exercise with weight loss? Are you motivated to work out or do you have to push yourself to get out and do it? Do you look forward to your workouts? Do you use exercise to compensate for eating too much? Do you feel rested and recovered? Etc 12345678910 How good is your current relationship with your mind? (if rated 6 or less please explain in box below) + Are you emotionally triggered by the number on the scale? Do you get happy when you see a low number but upset when it's higher than expected? Are you coping with stress well? Do you feel motivated? Are you engaged with the process or are you frustrated with the current outcome? Do you judge your progress mostly by what your weight says? Do you value non-scale victories equally? Do you feel like a failure when you mess up? 12345678910 Is there anything else you'd like to tell or ask me that might help me better customize your program?