Lifestyle Audit

Name

Trevor Flowers

trev23uk@gmail.com

Date

Monday, August 26, 2024

Gender

Male

Body Mass Index

24.2

Body Mass Index Status

Healthy Weight

Basal Metabolic Rate

1618

Total Score

41%

Create your own automated PDFs with Jotform PDF Editor- It’s free

Goals & Activity Levels

What would you like to achieve in the next 3-6 months?

Lose weight

Achieve a healthy body composition

What barriers or challenges have stopped you achieving your goals in the past?

No Motivation

Inconsistent Routine

Q1) How would you rate your current fitness levels?

I feel unfit and out of shape, lacking regular exercise.

Q2) How many hours do you currently exercise per week?

I’m not currently exercising

Q3) How many steps do you average per day?

5,000-10,000 steps / day

Q4) What best describes your daily work / occupation?

I spend a significant amount of time sitting at a desk.

Q5) Do you engage in activities to improve flexibility and mobility?

I regularly incorporate stretching or yoga

Nutrition

Q6) What best describes your current diet/eating habits?

I maintain a balanced and nutritious diet, incorporating a variety of healthy foods.

Q7) How often do you eat out or order takeaway food?

I indulge in dining out or takeaway 1-2 times per week.

Q8) Do you ever find yourself snacking / craving sugary foods between meals or at night?

Rarely or never

Q9) How much water do you drink per day?

Less than 2 liters

Q10) Do you rely on coffee / energy drinks to sustain energy throughout the day?

I rarely consume energy drinks or coffee.

Create your own automated PDFs with Jotform PDF Editor- It’s free

Your Lifestyle

Q11) How would you describe your current energy levels throughout the day?

Moderate energy levels

Q12) On average, how many hours of sleep do you get per night?

Less than 6 hours or poor quality

Q13) How would you rate your stress levels on a typical workday?

Low

Q14) How many hours per day do you sit and watch TV / Netflix?

3-4 hours

Q15) How many hours do you spend on social media each day?

3-4 hours

Q16) Do you smoke?

Yes

Q17) Do you drink alcohol?

Q18) Do you currently engage in any mindfulness or relaxation practices?

Regularly, a few times per week

Q19) How would you describe your morning routine?

I tend to hit the snooze button and react to the morning.

Q20) How do you typically spend your weekends?

I engage in outdoor activities, staying active and social.

Are you interested in receiving a personalized fitness and nutrition plan to achieve your goals?

Can I get more information

Create your own automated PDFs with Jotform PDF Editor- It’s free

About this template

Categories

Audit Report

Details

69 Clone

Created by

mytrainerae

Related templates

Daily Safety Inspection Report

Daily Safety Inspection Report Sample is an audit report, which is obviously crucial for any company to track the health and well-being of the employees. The fields in the template include equipment standards of workers.

Business

Supply Inventory Template

Generate a supply inventory form with this free template. Drag and drop to customize. Easy to share. Fill out and e-sign from any device. Converts to PDF.

E-Sign Audit Report

Technology Assessment Template

This free Technology Assessment Template includes a checklist for operational technology, technology support structure, hardware modernization and technology network in all areas of the restaurant.

Information Technology

Job Safety Inspection Report

Job Safety Inspection Report is another type of audit template to check whether a company is compatible with important safety measurements. This reports sample features critical fields on the safety of employees.

Insurance

Menu Compliance Audit Report

Menu Compliance Audit Report Sample provides you an effective way to report your findings each time you carry out menu compliance auditing. With Menu Compliance Audit Report PDF Template, health inspectors can easily create customized PDF reports.

Healthcare

Energy Audit Report

Energy Audit Report Template is used to assess the energy consumption of a company and how they can save more energy by optimizing the right items. In addition, you can easily modify the fields according to your immediate needs.

Services

These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.