Goals

Questionnaire

Please complete the following questionnaire so an action plan can be designed for you including mile stones and habit changes all to ensure your goals are met. Your goals will be revisited frequently to make sure progress is being made and that you are on track

Name
First Last
Date

Day
Month
Year
Goals
What are your three main goals for undertaking this coaching programme?
Goal 1.
Goal 2.
Goal 3.
Please write below if you have any other goals or things you want to achieve
Other Goals
If one of your goals is weight or body fat% loss and you haven't already stated a specific target date, please do so below.
Current weight (kg) / body fat%
Target weight (kg) / body fat%
Target Date

Day
Month
Year
Habits
Please list up to three habits that you think you'll have to work on most to achieve your goals?
Habit 1.
Habit 2.
Habit 3.
Future Aims
Taking into consideration your goals and the habits you want to change, please now answer the following time scale questions.
Where do you see your health and fitness in three months?
Where do you see your health and fitness in six months?
Where do you see your health and fitness in one year?
Where do you see your health and fitness in three years?
Where do you see your health and fitness in five years?
If there is anything else you would like to write that you think might help with the design of your programme please do so in the box below.

London Logo Onlty

Goals

Questionnaire

Goals

Habits

Future Aims