Client Check-In Form Name * Name First Name First Name Last Name Last Name What is your current weight? * Whats your current energy level? (1-10) 10 is best * 12345678910 Rate your mood this week. (1-10) 10 is Best * 12345678910 Stress Level (1–10) – 10 is Most Stressed. * 12345678910 How many hours of sleep do you get per night? * 4 or Less5 – 77 -8More than 8 + How often have you exercised each week? * Not at all 1 – 2 times per week 3 – 4 times per week 5 – 6 times per week How often have you tracked calories each week? * Not at all 1 – 2 times per week 3 – 4 times per week 5 – 6 times per week Every Day! Submit If you are human, leave this field blank.
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