Pleasure to meet you! We have a few questions about your habit so we can help you better.
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What does "healthier" mean to you?


 
Do you consider yourself "healthy" right now?

     
 
Describe your current health habits

Tell us what you can -- your current weight, what you eat,
 
How often do you exercise / hit your fitness goals?


 
How in control do you feel when you eat?

1 = not at all
5 = in total control





 
How often do you eat?

1 = only at meals / only when planned
5 = snacking all day





 
Why do you want to change your eating/fitness habits?

 
What obstacle(s) is holding you back from becoming the healthiest version of yourself?

 
Imagine your ideal healthy self, three months from now. What changed about you between now and then?

 
Have you ever worked with a coach or a personal trainer before?

     
 
On a scale from 1-5, how much would you benefit from having a health/habit coach?

1 = not at all
5 = I NEED a coach to keep me on track





 
Would you be interested in working with a Pavlok Coach to help you achieve your goals?

If so, we'll reach out with an application by email.

 
What's your name?

Thank you for submitting your answers.

At Pavlok, our mission is to help every single person achieve their habit goals.

The best way to succeed is with a coach. Schedule your first call with a Pavlok Habit Expert today.
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