Welcome to 5 to Thrive! 

I'm excited to support you on this journey to a healthier, happier you. You won't believe how GOOD you feel and how HEALTHY you can be by doing 5 simple things every day.

This initial questionnaire is designed to help me understand your current lifestyle, wellness goals, and wishes so I can include the most helpful information. 

Please take a few moments to complete this questionnaire. At the end of the program, you'll be asked to complete a similar questionnaire so I can gather feedback and measure your progress. 

Thank you for trusting me with your wellness and committing to a healthier lifestyle!



What was going on in your life that brought you to 5 to Thrive?*
Which best describes your health-related quality of life today? *
What are your top reasons for joining 5 to Thrive? Choose one or two.*
If weight loss is one of your goals, how many pounds do you need to lose to be at a healthy weight?*
A healthy diet emphasizes fruits, vegetables, and starches (beans, lentils, and whole grains) and at the same time, limits animal products (all meats, including chicken and fish, dairy, and eggs) and highly refined foods, such as white flour, refined sugar, and oil.  On a 0-10 scale, how closely does your diet resemble a healthy diet? Please choose one.*
How many minutes per week do you engage in exercise? *
How many hours of sleep do you get each night?*
How would you rate your quality of sleep?*
What gets in the way of your wellness goals? Please choose as many as apply.*
Are you ready to GO?*