Pre-screening and intake forms – Individual

Health screening is an essential part of developing and delivering a safe individual program. Health screening checks for any pre-existing conditions and risk factors that may require special care and health clearances or advisement from other medical professionals. Other elements of the form check your current nutrition, fitness and lifestyle habits, relevant to creating a sustainable program.

The form is mandatory under the Weight Management Scope of Practice under which I operate as a weight management practitioner.

It is important that you list your information accurately so that we can deliver the best and effect program to you. We tackle our health challenges and weight management with true authenticity and honesty is critical to the process. For example, if you are currently inactive, there is no judgment, but it is important that you say this. The same for food. We need to know where you are at. If you’ve got a serious chocolate habit – we need to know. We get the best results when you are honest.

In the case that you have medical conditions of concern, we will ask for your consent to contact your GP for comment and clearance for you to participate in weight management services.

This form exists at step 2 if this is required.