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Hypnotherapy
What Is Hypnotherapy
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FAQs
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Footzoning
Education
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What Is Foot Zoning
Book A Zone
Why I Started Zoning
Offerings
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Footzoning
Hypnotherapy
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WEEKLY CHECK-IN
Name
*
First Name
Last Name
Email
*
Any thoughts, breakthroughs, takeaways, or struggles you want to share about the week?
*
Daily Weigh-Ins
Every day, if possible!
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Measurements
Once per month, please! Remember to measure at widest area.
Right Arm
Chest
2" Above Navel
At Navel
2" Below Navel
Hips
Right Thigh
Right Calf
How many days did you track your food and stay within your calorie and macro ranges?
*
Did you complete all of the workouts and cardio sessions we agreed to this week? If no, why not?
*
Mindfulness
Meditation
*
How many days this week did you meditate for five or more minutes? This can include sitting in silence with your eyes closed (not while doing something else).
Zero
One
Two
Three
Four
Five
Six
Seven
Affirmations
*
How many days this week did you look at yourself in the mirror and repeat at least three positive affirmations related to your goals? (Affirmations may have been given by me or you may have created your own).
0
1
2
3
4
5
6
7
Emotionally, how did you feel this week?
*
Check all that apply
Defeated
Positive
Motivated
Ready to quit
Unstopabble
Done
Struggling
Satisfied
Excited
Fulfilled
Happy
On a scale of 1-5 (1 being completely checked out mentally and 5 being extremely motivated and unstoppable), how do you feel about the upcoming week? Can't use a 3.
*
1
2
3
4
5
Tell me about one thing you impressed yourself with during the week? Or one positive thing that happened in your life this week? Does not have to be fitness related.
*
Life is like...
*
If you had to finish the sentence "Life is like..." with this week (and only this week) in mind. What would you say?
Biofeedback
Rate your sleep this week:
*
How much do you agree with this statement?
Best sleep of my life!
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Rate your hunger this week:
*
How much do you agree with this statement?
I'm full all the time!
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Rate your stress level this week:
*
How much do you agree with this statement?
I'm not stressed at all.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Physically, how did you feel this week?
*
Check all that apply
Incredibly sore
A little bit sore
Energized
Somewhat tired
Exhausted
Not tired, not energized
Amazing
Just okay
Is there anything in particular you are struggling with that I can better assist you with for the upcoming week?
*
Commit to a goal for next week. What's one thing you WILL do better? Not try, but WILL. Does not have to be fitness related.
*
Do you have anything coming up this week that will hinder you from adhering to your current plan? If so, do you have a plan to work through it, or would you like my help to create one? Let me know here.
Anything else you might like to share, please leave it here.
Thank you!