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Why are you here?

You're here because you simply don't have the health, energy, or body you want. You either don't know where to start OR you feel like you're doing all the right things but it's not working. Something's missing but you don't know what it is.

 

ARE YOU IN THE RIGHT PLACE?

You're in the right place if you have been stuck at a certain weight, don't have clear direction on where you need to go from here or what to prioritize and you'd like to know the exact things to focus on to see progress.

 

WHAT DO YOU DO NEXT?

All you need to do is fill out this assessment with complete honesty and transparency. There's no "right" or "wrong" answers. From there you'll receive an email with some information and a call link to book in your review. I will also text you a 5 minute video with the main takeaways from your assessment so you know what we'll be diving deeper into on our call.

You can direct message me on FB/IG or email me at : contact@christinamcclurkenwellness.com if you have any questions!

Start

Question 1 of 22

Question 2 of 22

 

Question 3 of 22

Question 4 of 22

Question 5 of 22

Question 6 of 22

Question 7 of 22

 

Question 8 of 22

Goal Review Section

What is your primary health/wellness/weight loss goal? *

A

Weight Loss (more than 20 pounds to lose)

B

Weight Loss (less than 20 lbs to lose)

C

Improve body composition, fit more comfortably in my clothes

D

Health/Longevity (I want to manage a current medical condition or prevent future medical conditions. I want to feel my best for years to come!)

E

Aesthetics (I just want to look good naked! I have an event coming up I want to prepare for)

F

Other

Question 9 of 22

Question 10 of 22

(Select all that apply)
A

I've been dieting for as long as I can remember

B

I've been activelty trying to lose weight for the last 5-10 years

C

I've been actively trying to lose weight for < 1 year

D

I have never dieted before

Question 11 of 22

 How would you rate your protein intake? *

(Select all that apply)
A

1- Barely eating protein

B

2

C

3

D

4

E

5

F

6

G

7

H

8

I

9

J

10: Eating close to, at or above 1g of protein per pound of body weight (or protein with 2-3 meals/day)

Question 12 of 22

(Select all that apply)
A

Mostly processed / packaged

B

~50 % processed / 50% whole foods

C

Mostly whole foods ~80% / 20% fun foods

Question 13 of 22

How many servings of vegetables are you getting per day? *

(Select all that apply)
A

1-2

B

3-4

C

5-6

D

7-9

Question 14 of 22

How would you describe your overall food intake?

(Select all that apply)
A

I don't eat enough

B

I eat too much

C

I have no idea whether I eat to much or not enough

Question 15 of 22

How would you describe your hunger? *

(Select all that apply)
A

1 (rarely hungry)

B

2

C

3

D

4

E

5

F

6

G

7

H

8

I

9

J

10 (always hungry / thinking about food)

Question 16 of 22

Question 17 of 22

How would you rate your daily stress levels? *

(Select all that apply)
A

1: No stress at all

B

2

C

3

D

4

E

5

F

6

G

7

H

8

I

9

J

10: Very high levels of stress

Question 18 of 22

(Select all that apply)
A

6 or less hours

B

7 or less hours of sleep per night

C

7-9 hours of sleep per night

Question 19 of 22

(Select all that apply)
A

2,000-4,000

B

4,000-6,000

C

6,000-8,000

D

8,000-10,000+

E

I don't track my steps

Question 20 of 22

(Select all that apply)
A

No exercise routine

B

1-2 days/week

C

3-5 days/week

D

6-7 days/week

Question 21 of 22

Question 22 of 22

This assessment is not about coaching but are you interested in hearing more about 1 on 1 coaching? *

(Select all that apply)
A

YES

B

NO

Confirm and Submit