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GAME PLAN


First Name:
Last Name:
Date:            

ACTION STEPS

Your desired weight for your height is . . . .

Height: ft. inches

Weight: lbs.

Your current weight & height is . . . .

Height: ft. inches

Weight: lbs.

In order to achieve this goal, you must begin to lower
your caloric intake, convert some of your existing fat
into muscle and raise your metabolism by increasing
your areobic activities.

Fat Percentage: %
This measurement can be lowered using a variety of
exercise programs. It is improtant to walk before you
run for a number of reasons. You certainly want to
reduce your risk of injury. You also want to make
sure this is enjoyable. Some of the pleasure will
come from seeing results. Other will come from
meeting new people.

BMI Body Mass Index %

Energy Level:
This measurement can be increased with a better
diet, an infusion of regular exercise and a slight
attitude adjustment.

On a scale of 1 - 10 with 1 being sluggish, lethargic and slow
and 10 being peppy, energetic, active and totally alive.

Attitude:
This is a key factor in improving your overall health
and fitness. This is one of the most difficult as you
will face obstacle after obstacle on the course leading
to optimal health and fitness.

On a scale of 1 - 10 with 1 being negative, sarcastic and
depressed and 10 being positive, happy, optimistic & helpful

Nutritional Intake & Consumption:
This measurement is significant from the standpoint
of relating to the adage - garbage in, garbage out. The
other expression that bears noting is the one that says,
" You are what you eat." In this case, if your goal is to
generate energy and feel good about making progress,
then you nmay have to learn new dietary skills and
change your source of fuel.

On a scale of 1 - 10 with 1 being your diet is filled with soda,
fast food, chips and other junk food and 10 being an Olympic
styled training table with fruits, veggies and 8 glasses of water
per day.

Skin Care:
This new commitment may require a whole new regimen with
regard to how you manage your skin. Thiscould be a time consuming,
and somewhat costly proposition but it is worth it. Your skin deserves
special attention and you can give it to yourself. The important thing to
remember is quality skin care starts from the inside out. What you eat
and drink will have an impact as well as what lotions, creams and
cleansers you use will.

On a scale of 1 - 10 with 1 being poor and 10 being smooth and clear.

Hair Care:
This measurement is representative of your current skin
condition. Place a number between 1-100.
1= poor, needs work. . . . . 100 = Excellent, Clear, Healthy

Weight:
This measurement is representative of your current weight
and identifies how many pounds you would like to lose.

Stress:
This measurement is representative of your current stress
level. Place a number between 1-100.
1= totally stressed. . . . . 100 = Minimal Stress, No worries

Heart Condition:
This measurement is representative of your current physical
condition with regard to heart problems, chest pain or tingling
in your arms and hands Place a number between 1-100.
1= Huge aches. . . .100 = No noticeable signs what so ever

Anatomy:
This measurement is representative of your current level of pain.
Specifically sore muscles, sore joints or sore bones. Place a
number between 1-100.
1= Huge aches and pains. . . .100 = No noticeable pain

WORK OUT HISTORY

1. Are you currently working out on a regular basis?
Yes
No

1b. If you answered no, Are you looking to get started
with a regular exercise program?

Yes
No

2. Do you do aerobic exercises 2-3 times per week?
Yes
No

3. Where do you currently workout?

4. Are you satisfied with the place where you work out?
Yes

No

5. Are you looking for a (new) place to work out?
Yes

No

 

 
 
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