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End of Year Health & Fitness Review
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* Indicates required question
Email
*
Your email
What is your name?
*
Your answer
What is your current weight?
Your answer
What is your ideal weight you would like to maintain?
*
Option 1
How many hours of moderated to intense physical activity do you do per week? E.g. 7/10 intensity
*
0-1
2-3
3-4
4-5
5-6
6-7
7-8
8+
How many push ups can you do in a minute (good technique)
*
<5
5-10
10-20
20-30
30-40
40+
Can you comfortably squat your bodyweight? (e.g if you weigh 80kg you can squat 80kg)
*
Yes
No
Maybe
How long would it take you to run 1mile?
*
>10 mins
8-10mins
6-8mins
4-6mins
One a scale of 1-10 how happy are you right now with your health and fitness? 1 = Very unhappy, 10 = Super Happy!
*
1
2
3
4
5
6
7
8
9
10
What needs to change for you to reach a 10?
*
Your answer
What are your negative habits?
*
Your answer
What habits do you want to change?
*
Your answer
What is one fitness goal you want to achieve this year and why is it important?
*
Your answer
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