Metabolic Status Assessment 
 ✨Please answer the questions to the best of your ability to determine if you have any signs of metabolic adaptation/damage.

For the scaled questions, rate yourself on the following: 1 (not at all) to 5 (frequent) for each question. 

At the end of the quiz, you will total your score.

From there, I will review and analyze your score compared to the scoring key to assess metabolic efficiency. 

During our 1-1 Strategy Call, I can will help you map out the steps (if needed) to repair your metabolism so you can finally achieve your desired outcome.🙌  

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NAME (First and Last)  *
DATE *
Email address - please! If you don't provide this, I won't be able to get back to you about the results  *
How often in a week do you experience bloating? *
How often within a week do you experience abdominal cramping? *
How often do you experience hunger cues or "feel hungry"? *
How often within a week do you feel tired or exhausted? *
How often do you experience an energy crash in mid-afternoon? *
How often within a month do you experience headaches or migraines? *
How often during a week do you have a regular bowel movement? *
How often during a week do you experience constipation? *
Do you experience excessive hair shedding or thinning? *
How often within a week do you wake up in the middle of the night? *
How often during a week do you struggle falling asleep? *
How often within a month do you experience mood swings? *
How often within a week do you feel anxious or experience panic attacks? *
How often during a week do you feel depressed? *
How often within a week do you feel muscle weakness or fatigue? *
Please give me the score from the questions above  *
What is your age? *
Height (in cm OR feet & inches) *
Current weight *
Ideal "wellness weight" - meaning a weight that would be sustainable without extremes, that you would be happy and healthy at, NOT your lowest weight *
What are your goals *
Current calorie intake (on average per day) *
Do you have a history of dieting, or eating less than 1300 calories per day?
Pick the one that closest describes your daily activity - on AVERAGE throughout the week *
What best describes your weekly workouts? *
How would you rate your food quality? *
I don't really pay attention to food quality
I eat 80% whole foods & getting in my fruits and veggies
How would you rate your protein intake? *
I eat mostly carbs & fats
I incorporate protein in most meals & snacks
Do you consume a large quantity of caffeine to boost your energy throughout the day i.e. coffee, tea, energy drinks? *
How would you rate your daily stress levels? *
Very low
Very high
How many hours of sleep do you get each night on average? *
Do you have a history of doing excessive cardio or exercise?i.e. Running a lot, working out 6-7 days/week, going to the gym multiple times each day *
Does it feel like it's getting harder and harder to lose weight and/or keep it off even through you're still doing all the right things? *
What is your phone number so I can text you when I have your score & we can set up a time to discuss your results  *
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