Readiness for Change

Name*
First name Last name
Email address*
Mobile number*
Do you look in the mirror and feel frustrated, upset, or humiliated because of how your body looks?
- Yes (+3)
- I’m not sure (0)
- No (–3)
When you feel run down and tired, what do you think is the source of these feelings?
- Getting older (–1)
- My lifestyle choices (+3)
- Something else altogether (–3)
Are you taking any medications for heart disease, high blood pressure, or type II diabetes that you didn’t have to take when you were younger?
- Yes, I’m on two or more of these medications (+3)
- Yes, I’m on only one of these medications (+1)
- No, I’m not on any of these medications (–3)
If your fitness has deteriorated over the years, how do you explain the fact that you’re in worse shape than when you were younger but haven’t changed your habits at all?
- a) I think it’s my family history (–1)
- I think it’s that I’m less active (+3)
- I think it’s a natural consequence of aging (–1)
- I don’t know why it’s happening (0)
If you don’t have anyone to exercise with regularly, are you willing to look for a physical activity partner?
- Yes (+5)
- No (–5)

Are you ready to spend less time with people who offer little or no social support for your goals while spending more time with those who do offer support?
- Yes (+5)
- No (–5)
If a friend or loved one suggests that you don’t have what it takes to get into great shape because you’ve failed before or for some other reason, what will be your response?
- I can do it (+2)
- I know I’ve got to make some changes but I’ll take it one day at a time (+5)
- Maybe I can’t do it (–5)
Are you willing to wake up in the morning a bit earlier and stay up at night a bit later to accomplish your goals?
- Yes (+5)
- No (–5)
Are you willing to slowly work up to five hours of physical activity each week?
- Yes (+5)
- No (–5)
Your score and what it means
Once submitted, we'll add up your results and get in touch with you to discuss

Your score and what it means