Fill It Out!!!

This progress form is a way for us to see how you are doing & feeling concerning your nutrition and overall mental health. Take a few minutes and reflect:)

Strive for progress, not perfection.

Progress Form

Name

First Name

Last Name

Describe how these past few weeks have felt. What has worked? What hasn't worked?

Explain!

How have you felt over these past 30 days?

Select which applies.

The same as before

A little bit better

Feeling more healthy

Much happier

What were the key wellness habits you followed?

Will you add or subtract any of these habits to your daily routine?

Line

Take a moment and reflect: how will you continue to improve your daily routine by increasing positive habits?

What is the most important thing you have learned about yourself or realized.

Explain. This can be a weakness or a strength

Fill It Out!!!

Stephanie Gardner Wellness