Name
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First Name
Last Name
What do you think you have achieved from this 4 weeks?
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How has your relationship with food changed in the last 4 weeks and has it been realistic & achievable?
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How have you found the exercise during this last 4 weeks, have you enjoyed it and would you like to continue to now including exercise in your life?
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What barriers are still there that hold you back from living a healthier lifestyle?
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What would be a REALISTIC ideal exercise plan be like for you going forward? Do you prefer to walk or jog, do HIITS, do more weights?
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What would a REALISTIC ideal dietary plan for you? Calorie counting, Macro tracking, a set food plan or making small changes? What would work best for you and your lifestyle now knowing what you know?
Please be honest, if you have other ideas please say.
How may days a week would you like to fit in exercise?
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Please give details of times available.
Would you change anything about the last 4 weeks?
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Include changes you think i could make as much as yourself.
How do you feel about your body since starting the 4 weeks to fit?
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What improvements have you seen in your life since starting the 4 weeks to fit?
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Are you proud of yourself for the last 4 weeks?
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How are your energy levels now compared to before?
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What positive changes have you made in the last 4 weeks that you will carry on?
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Now knowing what you are able to achieve what is your goal?
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To evaluate your progress you need to provide photos. Please advise if you will be sending images over.
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All images must be emailed to progress@phbp.co.uk within 24 hours of submitting this form.
Please title email with: Full Name - Progress Photos
Waist (cm)
Belly Button (cm)
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Hips (cm)
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Bum (Widest Part) (cm)
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Upper Thigh, Left (cm
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Upper Thigh, Right (cm)
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Upper Arm, Left (cm)
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Upper Arm, Right (cm)
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Please confirm that you have read, understood and accurately completed this questionnaire. That you are voluntarily engaging in an acceptable level of exercise, and you understand that your participation involves risk of injury.
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I CONFIRM AND AGREE
I DO NOT CONFIRM AND I DISAGREE
Is there anything else you would like to share or document for your records here??
Finally if you wish to share a review for me to be able to use (unnamed) on social media then please write it here...this is not mandatory and i will think no less of your beautiful self if you dont wish too.