This free survey is powered by
0%
Exit Survey
 
 
I believe I can make the recommended changes to reach a healthy weight.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree

 
 
 
I understand the risk of developing other more serious diseases if I remain at an unhealthy weight.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
 
 
I feel like I am ready to take action regarding implementing the components of a healthy lifestyle.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
 
 
I am able to keep my calorie intake to the recommended amount for me.  
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
 
 
I am able to get a variety of proteins, carbohydrates, and healthy fats in diet.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
 
 
I feel confident in my ability to get enough physical activity.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
 
 
I routinely get the minimum recommendation for physical activity.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
 
 
I feel confident in my ability to reach my goals.
 
Strongly disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
 
 
I have everything I need to fulfill my plan to reach my goals.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
 
 
I believe that I have enough support to accomplish my goals.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
Share This Survey:          Surveys Powered by  QuestionPro Survey Software