Survey – Welcome Thank you for completing this initial survey, which should take 15-20 minutes of your time. To best support your success during your Whole30, it’s important that I understand what brought you to Whole30, what your current goals and challenges are, and what you hope to gain during the next 30 days. The first section of this survey contains personal information, but no questions about your medical history. This data will be shared with me (your Coach) and with the staff at Whole30 HQ for private use only. The second section of the survey contains optional questions about your medical history. This portion is anonymous. Both I and Whole30 HQ will only see the data in a group, not by individual survey results. We hope you will take time to complete this survey, because the data is extremely useful to us in better understanding how clients like you are experiencing the Whole30, which will help Whole30 develop more effective education. The questions asked on this survey and the information collected here is in no way intended as medical advice or as a substitute for medical treatment, and should only be used in conjunction with the guidance, care, and approval of your physician. Nothing herein is intended to diagnose, treat, cure or prevent any disease. Part 1–You and Your Whole30 Coach Name(Required)Contact InformationName(Required) First Last Email(Required) Phone(Required)Preferred Form of Communication(Required) Text Email Phone Call If it’s something I decide to use for our group Whole30, can I include you in a group chat via a program like Slack?(Required) Yes No Your Whole30 HistoryPlease provide me with a little insight about what brought you to Whole30, and whether you’ve done a round before.How did you hear about Whole30?(Required) From a friend or family member From my medical provider From social media From Whole30 books or online resources Other How did you hear about Whole30 Coaching?(Required) Through the Whole30 website Through Whole30’s social media channels Through a Whole30 email newsletter Through a friend Other How did you find me?(Required) Through a friend Through the “Find A Coach” portal on whole30.com Through an advertisement Through my social media Other Have you ever completed a Whole30 before?(Required) Yes No How many Whole30s have you completed? Have you ever completed a Whole30 with reintroduction?(Required) Yes No Have you ever started but not completed a Whole30?(Required) Yes No If you answered yes to the question above, how many times have you started but not completed a Whole30? If you answered yes to the question above, which of the following best represents the reason you did not finish your previous round of Whole30? I wasn’t prepared enough Weekly meal prep became overwhelming I had a social event during my Whole30 that derailed me I didn’t have enough accountability to keep me going I felt the cost of compatible food was too high My cravings became too much Have you ever worked with me before?(Required) Yes No Have you ever used another Whole30 Coach before?(Required) Yes No If so, name: Are you completing this Whole30 as an individual client, or as part of a group?(Required) Individual Group Are you enrolled with me as a virtual client, or in-person?(Required) Virtual In person Your Current Approach to FoodYour answers in this section help me better understand how you’re eating now, which can help me better understand what your experience will be like on Whole30. Which of the following most closely describes your current nutritional approach? (Please check all that apply.)(Required) High in processed foods, refined carbohydrates, and refined sugars (Standard American diet) Paleo Carnivore Keto Vegetarian Vegan Intermittent fasting Irregular eating patterns 3 meals per day, with no snacking I cook 80% of my meals I eat more than 50% of my meals from a restaurant I focus on low-fat eating Which of the following best describes your relationship with hunger cues? (Please check all that apply.)(Required) I am often not hungry and have to force myself to eat. I snack often. I eat when I am hungry. I am hungry most of the time. I eat at prescribed times and ignore my hunger cues if they fall outside those times. Do you experience a “slump” in the mid-afternoon each day?(Required) Yes No Which of the following most closely describes your current sleep patterns? (Please select one.)(Required) I sleep well through the night and wake rested most days I wake frequently through the night I sleep less than 7 hours every night I consider sleep a struggle for me Do you enjoy cooking?(Required) Yes Sometimes Not really Do you have any food allergies?(Required) Yes No If you have food allergies, please specify: In your own words, what is your current relationship with food? In your own words, how do you think changing your relationship with food might benefit you? Your Whole30 GoalsYour answers in this section will help me (and you) keep sight of your goals as we work together during your Whole30 round! Which of the following do you most hope to gain from Whole30?(Required) Taming my “Sugar Dragon” Identifying foods that might be contributing to pain (like joint pain) Addressing persistent gastrointestinal issues Better sleep More knowledge of how my body responds to food More love and acceptance for my body Body composition changes In your own words, what is your primary goal for doing Whole30? What do you see as being your biggest challenge during your Whole30? Do you have any major gatherings, events, or travel scheduled during your Whole30? Is there any other information you want to share with me?
