Module 4: Done for You Resources
1 | Confirmed you understand and will follow the use and attribution guidelines as directed. |
As an INE student, you have permission to use the resources on this page for your professional use with your clients.
You are welcome to distribute the materials on this page “as is” (with the existing footers) or personalize them as long as you put ONE of the following acknowledgements on each page in the footer:
- Distributed by your name with permission.
© Dr. Ritamarie Loscalzo, MS, DC, CCN, DACBN, Institute of Nutritional Endocrinology (INE) www.DrRitamarie.com - Adapted by your name with permission.
© Dr. Ritamarie Loscalzo, MS, DC, CCN, DACBN, Institute of Nutritional Endocrinology (INE) www.DrRitamarie.com
When you’re first starting out, you can save time by using these forms as is and giving them to your clients to complete. As time goes on, you will probably want to create some of your own forms, using questions from these as guides. Feel free to rephrase things to reflect your own voice and the need of your specific clientele.
Pillars of Health Assessments – Body Freedom Foundations – Identify Obstacles
- 7 Pillars – Body Freedom – Scorecard Assessment (PDF)
- 7 Pillars– Body Freedom – Scorecard Assessment (DOCX)
Fun
- Fun Assessment Scorecard (PDF)
- Fun Assessment Scorecard (DOCX)
Restful Sleep
- Sleep Habits Assessment (PDF)
- Sleep Habits Assessment (DOCX)
Exercise
- Physical Activity Frequency and Duration Assessment (PDF)
- Physical Activity Frequency and Duration Assessment (DOCX)
- Exercise Assessment (PDF)
- Exercise Assessment (DOCX)
- Body Measurements Tracker (PDF)
- Body Measurements Tracker (DOCX)
- Fitness Test Assessment (PDF)
- Fitness Test Assessment (DOCX)
Environment
Diet
- Diet Assessment Scorecard (PDF)
- Diet Assessment Scorecard (DOCX)
- Diet and Symptom Tracker (PDF) (FAST program)
- Diet and Symptom Tracker (XLSX) (FAST program)
- Dietary Habits Assessment (PDF)
- Dietary Habits Assessment (DOCX)
- Food Frequency Checklist (PDF)
- Food Frequency Checklist (DOCX)
Outlook
- Attitudes and Beliefs Assessment (PDF)
- Attitudes and Beliefs Assessment (DOCX)
- Values, Visions, and Goals Assessment (PDF)
- Values, Visions, and Goals Assessment (DOCX)
Mindfulness
- Stress Level Assessment (PDF)
- Stress Level Assessment (DOCX)
[accessally_course_navigation prev_button=’Previous’ next_button=’Next’]
