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Increased Body Awareness
Smart Goal Setting
Accountability To Your Goals
Improved Quality of Life
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Prism Pro-Active Program
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Pre Exercise Questionnaire
Date of Birth
Date Format: MM slash DD slash YYYY
Please tick next to the main benefits you want from your excercise and diet program:
What sort of training have you done previously?
What training are you doing now?
Goals in order of priority:
Goals in order of priority: 1
Goals in order of priority: 2
Goals in order of priority: 3
Please tick the area(s) you need most help with:
YOUR FIRST STEPS
How important is it for you to achieve your goals on a scale of 1-10?
How committed to change are you on a scale of 1-10?
How long have you been thinking about achieving these goals?
Why haven’t you achieved these goals yet?
Do you currently have any injuries? If so what is the injury and how are you fixing this?
In 6 months time, what would you like to have achieved?
Are you ready to take action now?
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