New Member Questionaire

Are You Ready To Succeed?

Health History:

The following questions are to help determine your current state of health. If you answer yes to two or more of the following questions it is essential that you consult with your physician prior to embarking on a new fitness program!

1.Are you a male over 45 years of age?

2. Are you a female over 55 years of age?

3. Has your father or brother had a heart attack, stroke, cardiovascular disease or sudden death prior to age 55?

4. Has your mother or sister had a heart attack, stroke, cardiovascular disease or sudden death prior to age 65?

5. Have you been told you have high blood pressure? 140/90 mmHG; or are you on Blood Pressure Medication?

6. Do you have high cholesterol? 200 mg/dl or higher?

7. Do you have diabetes?

8. Do you smoke? Have you smoked in the past 10 years?

9. Do you get little or no exercise or physical activity throughout the day? Do you lead a sedentary lifestyle or are you currently obese according to the BMI Scale?

10. Do you have a heart condition?

11. Have you ever had chest pain, or experienced chest pain brought on by physical activity?

12. Have you ever had a stroke?

13. Do you have a tendency to lose consciousness or balance due to dizziness?

14. Do you have bone, orthopedic or joint problems that affect or could be aggravated by physical activity?

15. Do you have chronic bronchitis?

16. Do you have asthma?

17. Do you have a chronic illness or condition?

18. Are you, or have you been pregnant within the last three months?

19. Are you currently taking any doctor prescribed medications? Would any of these medications affect you during a physical workout?

20. Are you aware of any reason through your own experience or a doctors advice why you should not participate in an exercise program?

What is your fitness deadline? What is that date in the future that you want to look and feel your absolute best by? Be sure to set a realistic goal for yourself, if you are focusing on a certain amount of weight loss remember that a good rule of thumb for healthy weight loss is 1-2 pounds per week.

What are your fitness goals? List them out.

Can you truly envision yourself as fit and healthy? Do you truly believe that you can do it? It is very helpful to truly start picturing yourself in the fitness state that you would like to be, believing that it is possible for you, and understand that you can accomplish whatever goals you set your mind to!

What does fit and healthy mean to you? In your ideal fit and healthy world, what do you look like? What do you feel like? How is that different from what you look and feel like now?

Do you think you have a healthy nutrition program right now? Describe what a day of eating looks like for you.

Do you feel like you are ready to make the necessary changes to your diet in order to achieve your fitness goals? Do you understand that 80% of weight loss is based upon your diet and how you are fueling your body?

In the past you may have had similar goals to the ones that you have listed above. If so, what things held you back from accomplishing them in the past? What obstacles stood in the way of you and fitness success in the past?

What does your current exercise program look like? What are some different things you would like to add into your current routine? For example, are there cardio activities you would like to try or would you like to try consistently adding strength training? What would you like to change about your current fitness routine? How important to you is it to make these changes? How long do you think it will be before you can adopt these new routines as a consistent part of your lifestyle?

What is going to be different this time? What are you going to do and commit to this time around that are going to help you succeed this time? (Your D2BFit support team is one!) What strategies can you implement into your daily routine that are going to help you succeed on your fitness journey?

What do you think will help to motivate you to start leading a fit and healthy lifestyle? For example if one of your goals is weight loss, why do you want to lose weight? Is it to prevent obesity related diseases? Is it so that you can look at yourself in the mirror and be proud of what you see? Is it to set a good example for your children? Are these goals truly what you want for yourself or do you want to succeed for the sake of someone else (for example a spouse or other family member)?

Think about your daily schedule, are you willing to make the time necessary to start making positive healthy changes to your lifestyle?

What are your priorities in life?

How does good health and a fit lifestyle tie in with your priorities in life?

What are your goals in life?

How would leading a fit and healthy lifestyle help you accomplish your goals, or how would it tie in with you succeeding with your life goals?

What is a goal that you have set for yourself in the past and then succeeded at? What did it take for you to succeed? Did you have to make changes in order to accomplish this goal?

Are you ready to make and sustain changes in at least one area of fitness, whether that is nutrition or exercise?

Are you ready to change?

There are several stages to change, determining what stage you are in can contribute tremendously to your fitness success. It is possible that you are not in a stage where you are willing to change just yet. If that is the case it may be better for you to commit to changing your lifestyle at a different time when you are more mentally prepared. The following levels of change are based on the trans-theoretical model of change which says that you actually have to go through a mental process in order to incorporate changes into your lifestyle. Review the following levels of change and see if you can identify what level you believe you are at.

Pre contemplation - I can’t or won’t change

Contemplation - I may change

Preparation - I will change

Action - I am in the process of making changes

Maintenance - I am in the process of maintaining the changes I have made

Those who are going to have the most success with the D2BFit program are going to be in the Preparation, Action, and Maintenance states if you are not there yet though we can help you get there! Let’s get started!

D2BFit strongly encourages you to share your answers to this questionnaire on the online forum. If there is information about yourself that you are uncomfortable sharing at first that’s perfectly fine, it is our hope that as you become comfortable with the D2BFit environment you will understand that the more you share with us the more we can help you! Get on the forum and tell us about yourself, share as much as you want and let us know what your fitness goals are, we are going to be providing information on how to develop a fitness vision and how to set short term and long term goals for yourself, how to get your nutrition under control, how to incorporate fitness into your busy lifestyle and so much more! Get started and get involved today! We can’t wait to get to know you!