Accountability Challenge Baseline

Name*

First Last

Date*

Email*

Write a paragraph here to dump your thoughts, feelings and frustrations about your (our) current situation, including any rants that you want to have to get it off your chest - no one will see this apart from Nicola (your accountability coach)*

Well-being score card. Clarity is how clear and certain we feel about the changes that we want to make and how sure we are of our next steps. Score yourself from 1-10 in this area so that you have a baseline. Type your score in the box below. (1 is worst, 10 is best)*

If you are unsure what this means, an example would be 1 = you feel totally lost, and have no clear direction to go in, your motivation is hanging by a thread 10 = you feel super clear and driven, with a well mapped out plan of action

Well-being score card. ENERGY is how prepared and well you feel to complete the daily activities that are important to you, whilst not losing focus or drive. Score your current energy levels on a scale of 1-10 (1 is worst, 10 is best)*

Well-being score card. CONFIDENCE is how you feel about yourself, your self worth, your self esteem, your self determination to get what you want. Score your current CONFIDENCE levels on a scale of 1-10 (1 is worst, 10 is best)*

Well-being score card. FITNESS is the combination of your cardiovascular health, your strength, your power and your ability to do the physical activities that you want to do each day. Score your current FITNESS levels on a scale of 1-10 (1 is worst, 10 is best)*

Well-being score card. NUTRITION is your food choices, portion sizes, overall food knowledge and how this relates to your energy and wellbeing. Score your current NUTRITION level on a scale of 1-10 (1 is worst, 10 is best)*

Well-being score card. SLEEP HEALTH can be considered in terms of quantity, quality, effectiveness of bedtime routine and how your daily energy feels. Score your current SLEEP HEALTH levels on a scale of 1-10 (1 is worst, 10 is best)*

Well-being score card. STRESS is our response to the external world, and to our internal thoughts and feelings. Score your current STRESS levels on a scale of 1-10 (1 is worst, 10 is best)*

Weight baseline (kg) - (optional)

Waist measurement baseline (cm) (optional)

Tummy measurement baseline (cm) (optional)

Hips measurement baseline (cm) (optional)

Thigh measurement baseline (cm) (optional)

Arm measurement baseline (cm) (optional)

Body Fat measurement baseline (%) (optional)

Please only use this as a metric if you have a decent set of scales that measures it accurately.

Average daily calories baseline (optional)

You will only be able to submit this if you have been logging on myfitnesspal. Take the total calories from the last 7 days, add up ALL of those numbers and then divide by 7 to give me the average.

Progress photo baseline (optional)

Drop files here or

Max. file size: 96 MB, Max. files: 3.

Try to wear the same clothes (and bra if relevant) each time. Please no NAKED photos. Underwear photos are fine if you are comfortable sending this. You may upload a maximum of 3 photos (front, side, back)

Facebook Challenge Baseline