Castellanox Assessment

Answer a few focused questions so we can understand your goals, lifestyle, and challenges and build a plan tailored specifically to you.

Full name

Email

Birthday

Day

Month

Year

Why is this goal important to you?

If we fast-forward 6 months… what would success look like for you?

How would you describe your current fitness level?

Beginner

Intermediate

Advanced

How active are you currently?

Not active

1-2 times per week

3-4 times per week

5+ times per week

What does a typical day look like for you?

Do you have any injuries, pain, or physical limitations?

Yes

No

If YES: “Please explain”

Do you have any medical conditions I should be aware of?

Yes

No

If YES: “Please explain”

Are you currently taking any medication?

Yes

No

If YES: “Please specify”

How would you rate your current nutrition?

Poor

Average

Good

Very good

What is your biggest challenge when it comes to nutrition?

How is your sleep on average?

Poor (under 5h)

Okay (5–6h)

Good (7–8h)

Great (8h+)

What has stopped you from reaching your goals in the past?

On a scale of 1-10, how committed are you right now?

What would make this program a success for you personally?

If you could change one thing about your body or health instantly, what would it be?

Is there anything else I should know about you to help you succeed?

Thank you for completing your assessment. Your answers will be used to create your personalized Castellanox plan.