M&B Reset Questionnair | M&B Blueprint

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Thank you for joining the Mind & Body Reset Program.

This questionnaire will help me understand where you are starting from and what you would like to achieve. Your answers will allow me to tailor the coaching, training, and guidance to support your progress over the next 8 weeks.

There are no right or wrong answers — honesty will help us make the most of our work together.

Full name

Birthday

Day

Month

Year

Address

What made you decide to join the Mind & Body Reset Program now?

What are the three main outcomes you would like to achieve during the next 8 weeks?

How would you describe your current fitness level?

Beginner

Some experience

Intermediate

Advanced

Do you currently exercise? If yes, what type of training do you do and how often?

Do you have any injuries, medical conditions, or physical limitations I should be aware of?

What type of training environment do you have access to?

Full gym

Basic gym

Home training

Limited equipment

How would you describe your current lifestyle? Example areas: Work schedule, Stress levels, Energy during the day, Sleep quality, etc.

What have you tried before to improve your fitness or life direction? What worked? What didn’t?

On a scale from 1–5, how committed are you to making meaningful changes during this program?

5 - I’m fully committed to making meaningful changes and prepared to take responsibility for the process.

4 - I’m ready to take action and follow guidance to improve my habits and lifestyle.

3 - I’m open to making changes, but I may need support to stay consistent.

2 - I would like things to improve, but I’m not sure I can prioritise this right now.

1 - I’m curious about the program but not ready to make significant changes yet.

Is there anything else you would like me to know before we begin working together?

What would make this program a success for you?

Schedule an appointment

April 2026

Week starting Sunday, April 12

Time zone: Coordinated Universal Time (UTC)Online meeting

Thursday, Apr 16

10:00 AM - 11:00 AM

11:00 AM - 12:00 PM

12:00 PM - 1:00 PM

1:00 PM - 2:00 PM

Please select a date and time that works best for your first session.

If your chosen time has already been taken, I will contact you to arrange another time on the same day or a nearby alternative.

Please list 1–2 alternative days and times that would work for our weekly sessions.

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You Don’t Need to Figure This Out Alone

Take the First Step Today

You Don’t Need to Figure This Out Alone

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Take the First Step Today