Lifestyle Questionnaire

Please complete all questions honestly. You will not be judged! Your answers will help me to get to know you and for us to agree on the changes you will be able to make to your lifestyle in order to meet your goals.  

Name *
Name
Exercise and physical activity
Describe your exercise and activity history in the last 2 years.
Describe your current exercise and activity levels
Nutrition
For more information on what a portion looks like check out the NHS guide: www.nhs.uk/Livewell/5ADAY/Pages/Portionsizes.aspx
How often per week do you consume the following:
Lifestyle