Table of Contents

Essential Skills Assessment

Essential Skills Assessment

This assessment can show us how consistently and well you do some of the essential nutrition and lifestyle practices. There is no judgement here. This is just data. Having accurate information allows us to reach your goals better by working together.

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Thank you! Your responses have been submitted.

Your Assessment Results

    Eating Habits Questionnaire

    Eating Habits Questionnaire

    There are no right or wrong answers. Please answer the questions as honestly as you can.

    General Eating Patterns

    As best as you can remember right now, tell me generally about an average day of eating and drinking. This doesn't have to be perfect; just capture your usual patterns.

    1 (All over the place) 10 (Very Consistent)
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    Hunger Cues & Appetite

    1 (Never hungry) 10 (Always hungry)
    5

    Daily Habits and Environment

    1 (Terrible/Nonexistent) 10 (Chef-level)
    5

    Goals & Priorities

    Thank you! Your responses have been submitted.
    Change Capacity Assessment

    Change Capacity Assessment

    How can I change successfully?

    Change isn't just about how much you want to change. It's about the change-making skills that you have, or are willing to learn and practice. This assessment can help me know what next steps will most help you change and reach your goals. Please be as honest as possible. There is no judgement here. These are just data. Having accurate information allows us to work together to help you reach your goals.

    Take the assessment: Answer the following questions based on your current circumstances. Please read all questions and scoring options carefully.

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    Thank you for your responses. Your assessment has been submitted.
    Food & Feeling Journal

    Food & Feeling Journal

    There are no right or wrong answers. Please answer the questions as honestly as you can.

    How to use this journal:

    Write down what you ate or drank and when, how you were feeling, and what you were doing. Keep track of things you found helpful and things that challenged you. You can fill out a few entries or just one. Feel free to use this as a daily check-in or a record of specific meals/days.

    Journal Entry 1

    Journal Entry 2 (Optional)

    Journal Entry 3 (Optional)

    Self-Assessment

    Thank you! Your journal entry has been submitted.
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