Stress & Recovery Questionnaire

The initial assessment questionnaire is designed to help me get to know you better and understand your unique needs, goals, and circumstances. This questionnaire is your first step towards a personalized and effective coaching experience.

The information you provide will enable me to create a tailored coaching plan that aligns with your aspirations, health status, and readiness for change. Your participation in this assessment is a crucial part of our collaborative journey towards a healthier, happier you.

The information submitted through the Initial Client Assessment Questionnaire is treated with the utmost confidentiality and respect. For more information regarding how the data is collected, stored and used, please see the Privacy Policy.

Thank you for taking the time to complete this questionnaire. Your input is invaluable, and I look forward to helping you on your journey toward improved health and nutrition.

Contact Information

Sleep Habits and Quality

Stress factors

Provide your answer on a scale from 1 (No Stress) to 10 (Extreme Stress).
Provide your answer on a scale from 1 (Horribly) to 10 (Perfectly).
Provide your answer on a scale from 1 (Exhausted) to 10 (Superstar!!!).
Provide your answer on a scale from 1 (Almost Nothing) to 10 (Excruciating).
Provide your answer on a scale from 1 (Total Brain Fog) to 10 (Genius).
Provide your answer on a scale from 1 (Completely Depressed) to 10 (Ray of Sunshine).
Provide your answer on a scale from 1 (I'd rather take a nap) to 10 (Let's crush it!).