WELCOME
to the VIP Elite Wellness Day Event

Let's get ready for your day by filling out the form below

Welcome to Ultra Nutrition

Congratulations on taking this important step toward improving your performance, optimizing your energy and health, and balancing your mood and hormones.

In order to optimize your experience, I want to get to know you better, your goals, and what you would like to get out of our time together. Please fill out the information below as thoroughly as possible. You will likely want to allow about 45 minutes to complete this form.

If you have any questions, please don't hesitate to reach out to email or text:

lauren@laurenbcallahan.com

318.589.8021

First name

Last name

Phone

Address

Age, height, and weight

Primary reason for seeking integrative wellness coaching

Other reasons you are seeking integrative wellness coaching

Let's take a look at your current training and nutrition habits.

Tell me a little about your current habits. Sunday through Saturday, what does a typical week look like for you in relation to exercise, work, and commitments.

What do you typically eat....

For breakfast?

For lunch?

For dinner?

For snacks and/or a fourth, fifth meal, etc.?

For any pre-, intra-, and post-workout fueling (what do you have before, during, and/or after exercise, if anything)?

What are you doing WELL? What have you done well in the past that you'd like to do more of?

If there was something you've done in the past that you'd like to do more of, is there anything that keeps you from doing this? (This is an honest question. No one thinks you're "making excuses". We're just exploring barriers.)

What would you like to do better? Why is that important to you?

What questions about nutrition do you have? What are you confused about, or would you like to understand better?

What are your top priorities when it comes to nutrition?

What is the best way I can support you in that?

What is important to you that we NOT cover or talk about?

Have you had any bad experiences with coaching or nutrition in the past that you want to make sure don't get repeated? Any really good experiences that you'd like to see again?

Let's look at your overall health. We'll touch on a lot of different topics that may give insight into your health, energy, performance, recovery, mood, and hormone balance.

Have you taken antibiotics in the past year?

Do you take a probiotic?

List any medications and supplements you take. Include if you take them regularly or intermittently.

Over the last month, how often, if at all, would you estimate you experience gastrointestinal upset (gas, bloating, nausea, cramping, diarrhea, constipation, etc.). Does this occur at certain times?

How much, if any, fermented foods do you eat each week?

About how many servings of fruits and vegetables do you have daily?

About how many servings of processed foods do you have daily?

What time do you typically start and stop eating each day?

Do you take any protein supplements? If so, how much and what brand?

About how much caffeine do you have daily? (If you are unsure, about how many caffeinated beverages do you have, how big/strong, etc.?)

About how much plain water do you have daily? (1 standard water bottle = 16 oz)

How many hours of sleep do you get daily on average? Do you have trouble falling or staying asleep? If so, please give details (does this change with alcohol intake, do you wake up to use the bathroom, etc).

On a scale of 1-10, how would you rate your stress level? Please explain why you gave that number. Is this typical for you?

Please share any medical conditions/diagnoses/history/relevant lab work/risk factors that you are aware of.

Do you have any chronic injuries or other chronic conditions not mentioned above? If so, please explain.

Do you regularly incorporate strength training into your routine? If so, how often?

What else do you want me to know about your overall health and lifestyle?

Now pause and take a deep breath..... What else is important to you? What else do you want me to know about you? What is your WHY?

One more deep breath.....When you walk away from our time together, how will you know it was successful?

WELCOME to the VIP Elite Wellness Day Event

Welcome to Ultra Nutrition

Lauren Callahan

WELCOME
to the VIP Elite Wellness Day Event