Lisa Fabry Nutrition & Yoga Therapy
Nutrition Stay on Track
Health Satisfaction Questionnaire
Name
Date
Please rate your satisfaction with the following areas of your life on a scale of 1 to 10
where 10 means 'couldn't be better' and 1 means 'I'm really unhappy with this area'.
Overall wellness
Energy levels (how awake, alert and focused are you?)
Motivation (how eager and enthusiastic are you for each new day, and for your future?)
Current eating habits
Body comfort (ie absence of pain or discomfort)
Current weight
Current fitness level
Body image
Work/rest/play balance
Stress levels
When you have completed this questionnaire, please press SEND to email to me. Your results will be kept confidential.
Send
lisa@lisafabry.com