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|
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Weight
|
|
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Weight trend
|
lbs since last visit
|
|
Ibs total
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Comments on Weight Loss
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Waist Circumference (every 4-6wks)
|
|
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Total Inches Lost Since Start Program
|
|
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BIA (every 4-6 weeks)
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PBF trend
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PBF change since last BIA
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PBF change total
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Diet
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Food Logging:
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Areas for improvement?
• • •
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Following Dietary goals?
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Additional Comments of Food Intake
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Exercise
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|
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Exercise Initial Assessment
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|
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No experience
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Not Consistent
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Consistently Exercising
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Limitations
• • •
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Types of Activity
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Intensity
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minutes/day
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Days/Week
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minutes per week
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Activity Comments
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