#1. What is your current height?#2. What is your current weight?
#3. What would be your ideal weight a year from now?
#4. How many servings* of bread / grains are you currently eating on a daily basis (give an estimate)?
* A serving is approximately a handful.
#5. How many servings of milk and/or milk products are you currently eating on a daily basis?
#6. How many servings of vegetables and/or fruits are you currently eating on a daily basis?
#7. How many servings of protein are you currently eating on a daily basis?
#8. How many servings of sugary snacks are you currently eating on a daily or weekly basis?
#9. How much water would you estimate you drink in a day?
#10. Do you drink alcohol? If so, estimate how much in a week.#11. Do you smoke? If so, estimate how much in a week.
#12. How many minutes of pure exercise would you estimate you do in a day?
#13. What physical activities do you currently enjoy?
#14. What physical activities are you interested in trying? ie. Archery, boxing, cycling, jogging, rollerblading, ice skating, etc.
#15. What physical activities do you remember fondly as a kid? ie. Road hockey, swordfighting with sticks, soccer, badminton, tennis, etc.
#16. How much time are you willing to commit to on a weekly basis towards exercise?
#17. Do you live or work in Downtown Toronto?
#18. How good is your posture when at work?#19. Do you eat out for lunch or bring a healthy meal every day?
#20. What is your primary reason for wanting to exercise more?
#21. How old are you?
#22. Do you have any medical problems I should be aware of?
#23. Do you have any back problems or are you seeing a physical therapist currently?
#24. Are you open to trying other activities that I feel will challenge you and be more fun?
Have a nice day!
