Weekly Assessment - Health Coaching and SCENAR training

Name *

Last name *

Email Address *

Date

Rate your average pain for this week *

Choose from the drop down menu. We will use this scale throughout the training.

Rate your healing crisis for this week *

Choose from the drop down menu. We will use this scale throughout the training.

How much has your pain dropped this week? *

0

1

2

3

4

5

6

7

8

9

10

See pain scale - 10 is worst

How many days was healing crisis? *

0

1

2

3

4

5

6

7

10 is worst

Rate your overall energy level *

1

2

3

4

5

6

7

8

9

10

1 is low energy, 10 is lots!

How motivated do you feel? *

1

2

3

4

5

6

7

8

9

10

1 low, 10 is lots!

How do you feel emotionally? *

How is your sleep? *

How is your digestion? *

How is your exercise? *

Primary pain *

Secondary pain *

3rd pain *

4th pain

Gloves, socks and body brushing *

Latest and significant 6 point readings *

Review goals from previous weekly log *

Examples: Less Pain, More Energy, Better Sleep, Improved Digestion, Better Mood, More Play, More Exercise, GMO free Diet, Organic Foods, Zero Salt, Get off Meds, More Time with Family, Get out More, Clean out Closet, Improved Fitness, Better Self Care etc.

Goals for next 7 days *

Examples: Less Pain, More Energy, Better Sleep, Improved Digestion, Better Mood, More Play, More Exercise, GMO free Diet, Organic Foods, Zero Salt, Get off Meds, More Time with Family, Get out More, Clean out Closet, Improved Fitness, Better Self Care etc.

Next week commitment hrs/wk *

Take imperfect action, learn from your mistakes, rinse & repeat. It works when you work it! 2 hours a day minimum except when indicated. Some people go 3 or 4 hours especially the first weeks. Allow 10 seconds for form to process.

Weekly summary *

Write a summary of the week ...

After the strategy call and when you upload the form to the Facebook group, post your Next 7 day goals in the post as a reminder

Weekly Self Assessment