Health & Wellness Assessment Form

Your journey starts here.

This comprehensive Health & Wellness Assessment is the first step in helping me understand you—your health history, current lifestyle, goals, and the areas where you need the most support.

Rather than taking a one-size-fits-all approach, this assessment allows me to prepare for our first session so our time together is focused, personalized, and productive from the very beginning.

During this assessment, you'll complete questions about:

✓ Health history and current medical conditions

✓ Physical Activity Readiness Questionnaire (PAR-Q)

✓ Current fitness and activity level

✓ Nutrition and lifestyle habits

✓ Stress, sleep, and daily routines

✓ Health goals and personal challenges

✓ Informed consent and program readiness

Please complete this assessment at least 24 hours before your scheduled session to allow time for review.

Your responses are kept confidential and are used solely to create a safe, personalized coaching experience tailored to your needs.

What's Included

• Interactive digital assessment

• Save your progress and return later if needed

• Printable PDF option

• Personalized review before your first session

This assessment is required for all new coaching clients.

Thank you for taking the time to complete it. I'm looking forward to learning more about you and helping you move toward lasting health—one intentional step at a time.

Janel Bilal

JanB Fitness

Helping You Nourish Your Body, Renew Your Mind & Live in Alignment.