Wellness Assessment
First name
Last name
Email
Phone
🟣 SECTION 1: GOAL
What is your main goal right now?
Fat loss
Muscle gain
More energy
Better sleep
Reduce stress
🔵 SECTION 2: SLEEP SCORE
How many hours do you sleep on average?
<5
5–6
6–7
7–8
8+
How would you rate your sleep quality? (1–10)
🔴 SECTION 3: STRESS SCORE
How stressed do you feel daily? (1–10)
Do you take time to relax or switch off?
Never
Rarely
Sometimes
Often
🟡 SECTION 4: ENERGY SCORE
How is your daily energy level? (1–10)
7. Do you experience energy crashes?
Yes (daily)
Sometimes
Rarely
Never
🟢 SECTION 5: NUTRITION SCORE
How would you rate your diet?
Poor
Average
Good
Very clean
Do you eat whole foods regularly?
Rarely
Sometimes
Mostly
Always
⚫ SECTION 6: MOVEMENT SCORE
How active are you?
Sedentary
Light activity
Train 2–3x/week
Train 4–6x/week
🟠 SECTION 7: RECOVERY SCORE
Do you do anything for recovery? (stretching, sauna, cold, etc.)
Never
Occasionally
Weekly
Daily
What do you struggle with MOST right now?
Sleep
Stress
Motivation
Digestion
Anxiety
Submit
Wellness Assessment