The Weight Loz Framework Weekly Check-In
First Name
*
Last Name
*
Email
*
Date
*
What clothing are you wearing during this check-in?
*
Gym
Work
Casual
Have you completed your weekend planning?
*
Yes
No
Current Weight:
Weight lost this week:
Total weight loss:
Current chest circumference:
Current waist circumference:
Current hip circumference:
Total cm lost:
Have you drank at least 8 glasses of water per day since your last check-in?
*
Yes
No
If not, why?
Have you eaten all your planned meals since your last check-in?
*
Yes
No
If not, why and what meals were missed?
Have you been hungry since your last check-in?
*
Yes
No
What have you done about it?
Have you had any cravings since your last check-in?
*
Yes
No
What did you do about your cravings?
How many hours sleep per night on average have you had since your last check-in?
*
Less than 5
5-7
7-9
9+
On a scale of 1 to 10, how has your stress been on average since your last check-in (1 = Not stressed, 10 = Very stressed)?
1
2
3
4
5
6
7
8
9
10
Have you had any alcohol since your last check-in?
*
Yes
No
If so, how many drinks and what?
Did you have any food outside your eating plan this week? Please list.
What physical activities have you engaged in since your last check-in?
*
What have been your biggest successes since your last check-in?
*
What have been your biggest challenges since your last check-in?
*
What non-weight-related goal will you set for between now and your next check-in?
*
Submit