Nutrition Coaching – Weekly Check-In

Please fill out the information below based on your experience from this past week.

Nutrition Coaching Client Weekly Check-in

Name

First Name

Last Name

Week Ending (Date)

How many times did you weigh in this week?

Body Weight Trend (Average of all weights recorded this week)

How closely did you follow the current plan this week? (0=Not at all 10= 100%)

Average hunger level this week (0=No hunger at all 10= Starving all the time)

Average daily energy level this week (0= Very Low 10= Excellent)

Average hours of sleep this week

How many days last week did you exercise?

Tell me about your exercise over the last week

What went well this week?

What was your biggest challenge this week?

Do you have any questions or concerns before next week?

If you are human, leave this field blank.

Jai will get back to you within 24 hours with any adjustments to the plan for this upcoming week.