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Weekly Feedback/Accountabilty Form
Please fill this form in every Monday morning.
But only if you want the best results from your time in the coaching programme!
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Please enable JavaScript in your browser to complete this form.
Today's date?
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Full name
Are you in Phase 1 or Phase 2?
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If in Phase 1, what week is today the start of - 1-12?
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On a scale of 1-Chuck Norris, how would you rate your adherence since your last check-in?
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1
2
3
4
5
6
7
8
9
10
Bruce Lee
Chuck Norris
What was the biggest challenge holding you back from giving the program 100% effort?
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Do you have any upcoming events that will hinder your ability to stick to your program and get results?
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What was your biggest lesson since your last check-in?
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Describe your previous week in one word?
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How much do you weigh this morning? (please ensure this weight is taken on an empty stomach, using the same scales and on a solid floor)
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How much did you weigh last week?
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What is your total weight loss so far?
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Are you happy with that result? – Yes/no – if no, why not?
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Average daily calories consumed since your last weeks check-in?
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Average daily grams of protein consumed since your last weeks check-in?
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Average water intake over the last 7-days?
Average daily step count over the last 7-days?
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Are you up to date with the bi-weekly coaching modules? If yes, great. Keep going. If no, catch up! They will really help you achieve your weight loss goal. Go into your App, look under guides. Voila!
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Yes
No
What could you have done differently this week?
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What worked well this week?
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How many times did you exercise this week?
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On a scale of 1-10 how would you score your stress levels over the last 7-days? 10 is HIGH.
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1
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5
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7
8
9
10
What could you have handled better this week?
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The biggest insight/lesson I learned this week was…?
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If I was coaching someone else in the same situation as me, the one piece of advice I would give them is…?
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What needs to happen over the next 30-days for you to label it as a success?
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Remind me of your FINAL weight loss goal?
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Are you committed to hitting it?
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Yes
No
LFG, Gav!
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