Mike

MIKE

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Full Name: *

First

Last

Lowest Weigh-In: *

Highest Weigh-In: *

Protein Average for the Week?: *

Carbs Average for the Week?: *

Fats Average for the Week?: *

Fiber Average for the Week?: *

Water Intake?: *

Not Great Average Awesome

Average Hours Slept per Night? *

less than 5 hours 5-8 hours 8+ hours

IF YOU ARE A FEMALE PLEASE GIVE THE APPROXIMATE DATE OF WHEN YOUR NEXT PERIOD WILL BE SO WE HAVE AN IDEA OF WHEN IT IS COMING *

Please rate your appetite/hunger levels on a scale of 1-10, 1 being not hungry at all and 10 being extremely hungry. Please explain (do not write just a number). *

Please rate your energy levels on a scale of 1-10, 1 being no energy and fatigued and 10 being extremely energetic. Please explain (do not write just a number). *

Please rate your mental health for the week and how well you coped with challenges on a scale of 1-10, 1 being poor and you did not cope well and 10 being excellent and you did cope well. Please explain (do not write just a number). *

Were there any changes in activity level this last week? Y/N and if yes, please explain. *

Questions/Concerns?: *

What Was This Weeks Struggle?: *

What was this weeks mini goal?: *

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