Goal Setting Survey

Name*

First Last

Email*

Where do I see myself in 3 months time?*

Where do I see myself in 6 months time?*

Where do I see myself in 12 months time?*

What do I want people to be saying about me and who do I want to be saying it?*

Why is this important to me?*

How will I feel when I achieve these goals?*

What are my strengths?*

What are my weaknesses?*

What are my barriers/obstacles to achieving these goals?*

How can I overcome these barriers?*

What support do I need to help me achieve these goals?*

Who can support me in achieving these goals and how?*

On a scale of 0-10 (0 being not motivated at all and 10 being highly motivated) how motivated am I to commit to a fitness and/or nutrition plan designed to help me achieve these goals?*

Name

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