Happiness in Motion

Client Questionnaire

This questionnaire contains some thought-provoking questions for you to consider before starting the program. This tool is meant to empower you to think clearly, become intentional,  and allow yourself to look for the answers. Think about what you want, what limitations you are currently living with, and how you can move forward into the life you desire.

Your Goals

What 3 changes do you most want to make in your life?

On a scale of 1-10 ( 10 being the most), how ready are you to make those changes?

On a scale of 1-10 (10 being the most), how happy are you?

Your Self

How would others describe you at your best, list 5 adjectives?

At your worst, list 5 adjectives?

What do you do for fun? 

Where in your life do you feel stuck? 

What causes you to feel motivated? 

What do you do for “self-care” routinely? 

Movement/Fitness

On a scale of 1-10 (10 high), what is your current fitness level? 

What type of movement/fitness do you enjoy and why? 

What type of movement/fitness do you avoid and why? 

What are you currently doing to move your body and how often? 

List the first 3 words that come to mind when you think about your relationship with fitness.

Describe a time in your life that you felt great in your body and why.

Thank you for taking the time to complete this questionnaire.