Your Personal Workout Prescription: pre-work What are you feeling? MOOD ❏ Relaxed ❏ Content ❏ Bored ❏ Fatigued ❏ Irritable ❏ Anxious ❏ Overwhelmed ❏ Angry ❏ Sad ❏ Depressed PHYSICAL SIGNS ❏ Headaches ❏ Neck/Shoulder Pain ❏ Back Pain/Injuries ❏ Fatigue ❏ Brain fog ❏ Trouble concentrating ❏ Trouble sleeping ❏ Poor digestion ❏ Weight Gain ❏ Heart palpitations What’s holding you back? ❏ Lack of time ❏ Lack of motivation ❏ Lack of know-how ❏ Lack of money ❏ Lack of support from family/friends ❏ Feeling unsafe ❏ Injury ❏ Disability What piqued your interest? (Leave blank until Saturday)