Check In (Jury) — Carson Laine Siler

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Please complete and submit this form. I am looking forward to hearing the details of your week!

Name

First Name

Last Name

HOW ARE YOU?

How are you doing? How was your week overall?

CURRENT WEIGHT

What is your current weight for your check-in today? If you are not weighing-in put NA

CYCLE

Day in the menstrual cycle, if applicable: (Example- Day 9) *note "unknown" if you do not track your cycle or do not have regular periods

STEPS

What was your step daily average this week?

WATER

Did you meet or exceed your water goal this week?

Yes

BIOFEEDBACK

PLEASE RATE THE FOLLOWING ON A SCALE OF 1-3 1 - being low/poor 2 - normal/average 3 - being high/great

ENERGY LEVELS:

On a scale of 1-3, how would you rate your overall energy levels for the week? (example: 1 = really low energy)

SLEEP:

On a scale of 1-3, how would you rate your overall sleep quality for the week? (example: 1 - less than 5 hours; 2 - 6-7 hours; 3 - 8+ hours

HUNGER:

On a scale of 1-3, how would you rate your overall hunger for the week? (1 = low hunger, 2 = normal hunger, 3 = hungry)

ADHERENCE:

Did you hit your macros/ nutrition goals within 5-10g of carbs, proteins, and fats each day? (yes or no) Tell me a little about it.

DIGESTION:

On a scale of 1-3, how would you rate your overall digestion for the week? (Rank 1-3, 1 = irregular, poor digestion, 2 = average, 3 = great, very regular)

STRESS LEVELS:

How would you rate your stress levels this week? Relatively low, mild and easy going Moderate, there are some ups & downs Very high, feeling the pressure

RECOVERY

How does your body feel this week? Rank 1-3, 1 = sore, achy, tired, 2 = average, 3 = great recovery.

WEEKLY REFLECTIONS

WINS THIS WEEK:

List two or more positives this week! This can be anything you have going on in your life and doesn't have to be just training or nutrition related.

OPPORTUNITIES FOR GROWTH

What needs improvement this week? Did you struggle with anything regarding your plan?

LOOKING AHEAD FOR NEXT WEEK

GOALS FOR NEXT WEEK:

What improvements do you think you can make/ change this upcoming week? This can be with anything you have going on and doesn't have to be just training or nutrition related.

OVERALL:

Any other questions, concerns or things I need to know?