Weekly Awareness Survey Make sure that you are logged in to the membership site before filling out this form to earn 10XP Points. Name(Required) First Last Email(Required) How would you rate your mood this week?(Required)123456789101 = Terrible | 10 = EcstaticHow would you rate your overall fatigue this week?(Required)123456789101 = Completely Drained | 10 = Not Tired At AllHow would you rate your motivation / drive this week?(Required)123456789101 = Zero Desire to Better Self | 10 = Could Not Stop Thinking About ImprovementHow would you rate your recovery this week?(Required)123456789101 = Feel Overwhelmed Physically & Mentally | 10 = My Body’s Recovery is the Best It Could BePlease answer accordingly for any anatomical area that you have pain and rate it from 1-10 (*If you have no pain, leave everything blank*)Toes012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Ankles012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Achilles012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Calves012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Knees012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Hamstrings012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Groins012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Hip Flexors012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)IT Bands012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Glutes012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Lower Back012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Mid Back012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Upper Back012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Lats012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Abs012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Shoulders012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Arms012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Wrists012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)Neck012345678910(0 = Blank | 1 = No Pain | 10 = I need to go to the doctor)What are your goals for this week? What do you want to focus on and grow in?(Required)(Doesn’t have to be movement related)
