Weekly Check-In

First name

Last name

What went well this week?

List 1-2 Things to Work On This Week

Body Weight

Chest

Waist

Abdomen

Hips

Thigh

Energy Levels This Week

Is there anything you would like to change?

Are there any barriers you have run into this week preventing you from achieving your goals?

Name 1 thing you can do to work around this barrier if able:

Nutrition

1 Habit to improve next week:

Digestion Rating

0-10, with 10 being great and 0 being awful

Stress

0-10, with 10 being extremely high stress and 0 being not stressed at all

1 self care activity I will do next week:

Sleep, Avg. hours per day:

Average number of hours of sleep you got per day (an estimate is OK):

Number of strength sessions completed:

How did it go?

Average calories burned per session:

Number of cardio sessions completed:

How did it go?

Average calories burned per session:

Are you experiencing any pain from certain exercises?

Any new health concerns?

Have you added any new medications?

Water intake (oz/day):

List other beverages you had this week: