Weight Loss Program Questionnaire
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Are you concerned about your weight.
Weight loss program questionnaire. If you are thinking about losing weight trying to lose weight in the process of losing weight or struggling to lose weight please take this short survey. Very important e. Date name medical record number address 1 phone number address 2 e mail 1.
Weight loss program questionnaire the ymca of burlington county and lourdes health system consisting of our lady of lourdes medical center lourdes medical center of burlington county and the lourdes wellness center are considering a joint program to support the weight loss goals of individuals in the communities we serve. We keep all information confidential. What did not work about these programs so we can make changes.
Endurance sport performance starting and sticking to a program weight loss core strength and low back pain bone health. What did you learn from these programs regarding your weight. Weight and lifestyle management questionnaire.
This diet promotes weight loss because again it is a very low calorie diet plan. Medical weight management program pre program questionnaire as part of our medical clearance we need certain information about your health. Toronto health and wellness centre brookfield place suite 3000 181 bay st po box 818.
How important is it that you lose weight at this time. Unlike other diet fads the military diet does not have any food exclusions. No skip to question 4.
Everything is totally confidential and i will not share your personal results with anyone. The information you share will help the registered dietitian have a better understanding of your needs. Have you maintained any weight loss for up to 1 year at any of these programs.
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