What is your current weight? What is your ideal weight?


    Names, ages, do they live with you?


    Do you have any pets? Describe the role they play in your life.


    What do you do and how many hours per week do you work? If you aren't working or are in transition, please explain.


    Is your lifestyle sedentary or active? Explain for both work and home.


    Describe your computer/tablet/phone and television viewing habits.


    Rank your level of stress on a scale of 1-10. What are the biggest stressors in your life? How does stress affect you?


    How and when do you feel connected to something greater than yourself?


    Please describe your emotional, physiological and social well-being on a day to day basis. Please include any mental struggles you face and any needs you feel aren't being met.


    Please describe your sleeping habits.


    Why are you seeking coaching right now? Where and how would you like to focus?


    Do you have any serious illnesses, chronic disorders or injuries?


    How happy are you? Explain.


    Please list the medications and supplements that you take.


    Are you involved with any healers, therapists, support programs or other advisors? Please explain.


    How often do you exercise? Is your current routine (or lack thereof) enough to sustain your desired level of fitness?


    Do you experience any cyclical symptoms?


    On a scale of 1-10, please rate your diet, with 10 being "couldn't possibly be healthier." How could your diet improve?


    Do you prioritize quantity, quality, taste, convenience, ingredients, food source and/or certain diet preferences? Do you manage calories, carbs, fat and/or protein ratios?


    Do you crave sugar, coffee, cigarettes, alcohol or fast food? What and when?


    Are you addicted to any substances (illegal, legal, prescription or otherwise)? How does addiction impact your life?


    What is your support system like? Consider spouse, family, friends, co-workers, etc. Where do you have support and where is it lacking?


    What is the most important thing you know you should do to improve your health?


    What motivates you? What do you procrastinate/avoid?


    Do you prefer professionals who tell you what to do? Or do you prefer lots of information and options so you can do your own research? Please comment on your personality style and preferences to health recommendations.


    Is there anything else you'd like to share?