Get Weight Loss Questionnaire

Filling out the Weight Loss Questionnaire online is a straightforward process designed to help you articulate your weight loss goals, motivations, and challenges. Each question serves a specific purpose to aid in customizing your treatment based on your individual needs.

Follow the steps to complete the questionnaire successfully.

1. Click the ‘Get Form’ button to access the Weight Loss Questionnaire and open it in your preferred online editor.
2. Begin by entering your name and the current date at the top of the form. This information is crucial for identifying your submission.
3. In the first section, provide your current weight and height. This data helps to establish a baseline for your weight loss journey.
4. Outline your exact weight loss goals in the corresponding field. Be specific about the amount of weight you aim to lose and the timeline, if possible.
5. Explain why weight loss is important to you in the next field. Your motivations can guide the therapeutic approach taken.
6. Address how weight is a problem for you. This question encourages self-reflection and helps convey emotional aspects associated with your weight.
7. Describe your activity level, mentioning types of exercises and frequency. This will help gauge your current lifestyle habits.
8. On a scale of 1 to 10, indicate your desire to lose weight. A higher number indicates a stronger motivation.
9. Next, rate your belief in your ability to lose weight on the same scale. This metric can reflect your confidence and mindset.
10. Reflect on the non-monetary sacrifices you are willing to make to achieve your weight loss goals. This question emphasizes commitment.
11. Indicate why you selected hypnosis as a weight loss method. Understanding your choice can be beneficial for the treatment process.
12. Provide a brief history of your past weight loss efforts and the duration of maintaining that weight. This can inform current strategies.
13. Detail any formal or informal diets you have tried and whether they were effective. Please indicate how long they worked.
14. List your primary care doctor’s name and phone number, which is helpful for coordinating your care.
15. Respond to the questions regarding smoking and alcohol consumption honestly. These factors can affect your weight and health.
16. Share any pleasant experiences or images that motivate you. This can enhance the therapeutic process.
17. List three skills or activities you excel at, as well as three things you enjoy doing. This can provide insights into your personality.
18. Identify your strengths, followed by specifying how many meals you typically consume in a day and when.
19. Respond to questions about snacking habits, meal preparation, and any instances of overeating. Include relevant details.
20. Detail your food preferences, dislikes, and cravings, along with meal skipping habits, to illustrate your eating patterns.
21. Conclude by indicating your biggest meal of the day and factors influencing your eating behavior.
22. Once you have filled out all sections, review your responses carefully for accuracy before proceeding to save your changes, download, print, or share the completed form.

Ready to take the first step towards your weight loss journey? Complete the Weight Loss Questionnaire online today.