INVEST questionnaire BEFORE COURSE — Empowered Coaching Co.

INVESTING IN YOU.

As part of the INVEST Program which is run in partnership with Crossfit Shire we ask those on the course to complete a questionnaire to measure where they are at during the run up to the first session as well as during the last week of the program. We do this as a way of helping measure your personal journey and development.

We keep your information confidential and it is used for the sole purpose of being able to measure your progress and aid those running the course to best support you. We would be grateful if you can take five minutes to complete the form below - being as honest as possible. Thank you.

Name

First Name

Last Name

Phone

(###)

###

####

Do you give us permission to hold your personal details for the purposes of this survey outlined at the top?

Yes

Personal Reflection

On a scale of 1-5 - 1 being not at all good - 5 being very good how would you measure how you feel about yourself in terms of the following?

1. Your self-esteem

2. Your body image

3. Your Fitness

4. Your mental health

Personal Outlook

2. On a scale of 1-5, 1 being not at all - 5 being totally how would you measure how you feel about your future regarding the following? 1 being not positive at all - 5 being very positive?

1. Your lifestyle

2. Your family life

3. Your work life

4. your future goals

3. On a scale of 1-5, 1 being not clear at all - 5 being very clear and confident, how would you measure how you feel about what you want to do with your life/ achieve with your life?

4. On a scale of 1 - 5, 1 being not confident and 5 being very confident, how would you measure your confidence in your fitness ability?

Thank you for taking time to complete this questionnaire. Please feel free to share any further comments you may have that it would be helpful for us to know?

How can we support you?

We want to give you the chance to mention if you would like anything that would aid you attend this program that we can assist or support you in, including but not restricted to accessibility, inclusitivioty or anything else that would enable you to feel at ease and welcome. Thank you.

INVESTING IN YOU.

You belong here.