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Health Inventory for Aging Well

Get Clear Before You Commit

You’re curious about how to feel better in your body—without burning out, getting injured, or wasting time.

This health inventory will help you and me get clear on your body’s current state, your health goals, and what’s standing in the way.

👉 Once completed, you’ll get a free downloadable PDF Blueprint and access to book your 15-min Clarity Call with me.

Contact Info

Birthday
Month
Day
Year

Body Feedback

Where do you feel discomfort or stiffness?
Have you been formally diagnosed with a chronic condition (diabetes, hypertension, auto-immune, etc)?
Yes
No
Other

Daily Life

How many days/week do you currently move or exercise?
0
1-2
3-4
5-7
Other
How would you describe your sleep?
Poor (<3hr)
Fair (3-5hr)
Good (7hr+)
Excellent (7hr+ & Quality)
Other
Do you regularly feel…

Wellness Priorities

What are your top 3 goals right now?

Reflections

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