Readiness Assessment Questionnaire

Are you READY to be the next person who successfully takes charge of their health, weight and lifestyle with our Telephone Counseling Program?

Simply answer the questions below and find out now.

Please be assured that your email address will be held in confidence

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* Please be sure to answer all the questions

1. Is shedding your unwanted pounds and keeping them off a high priority in your life right now? 1. Yes  2. Somewhat 3. Not at all
2. Do you know WHY you want to reach and maintain a healthy weight and positive lifestyle? 1. Yes 2. Somewhat 3. Not at all
3. Are you willing and prepared to put an end to yo-yo dieting once and for all? 1. Yes  2. Somewhat 3. Not at all
4. Are you willing and prepared to take full responsibility and be accountable for ALL of your food and lifestyle choices? 1. Yes 2. Somewhat 3. Not at all
5. Are you willing and prepared to review your relationship with food, your body and your inner-self? 1. Yes 2. Somewhat 3. Not at all
6. Are you willing and prepared to measure your success other than just the number on the scale? 1. Yes 2. Somewhat 3. Not at all
7. Are you willing and prepared to gradually integrate new healthier ways of eating into your day to day lifestyle for sustainable results? 1. Yes 2. Somewhat 3. Not at all
8. Are you ready to gain control over frustrating habits such as late night binging and compulsive eating? 1. Yes 2. Somewhat 3. Not at all
9. Are you willing and prepared to gradually incorporate more physical activity into your regular routine? 1. Yes   2. Somewhat 3. Not at all
10. Imagine yourself 2 years from now. You’ve shed your unwanted pounds and are managing to keep them off. Do you think your life will be much better from today? 1. Yes   2. Somewhat 3. Not at all
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