WATT

Enter your information below. * Required fields.

Enter your starting weight in pounds (lbs). *

lbs.

Enter your height in feet (ft) and inches (in). *

ft.

in.

Enter your waist and hip circumferences in inches (in).

in.

Select your current activity level. *

Sedentary Light Moderate Active Very Active

Select your health issues. Check all that apply. *

No Health Issues

Prediabetes (HbA1c: 5.7-6.4% or Fasting blood glucose: 100-125 mg/dL or 2-hour blood glucose: 140-199 mg/dL)

Diabetes

Hypertension

Heart Diseases

Please specify your food allergies. Select all that apply.

It is important for your coach and care team to know if you are allergic to any medication. Specify below.

Enter your information below. * Required fields.

Having personal health goals will help you stay more focused and motivated while on your journey toward better health. Write your personal subjective goal below.

Goal Weight*: Managing your weight is key to a healthy lifestyle. Set your goal weight.

lbs.

Your goal weight is too low. Please adjust.

You are underweight. Please try to gain weight for your health.

A rapid, significant weight loss may cause adverse effects on your health.

Your daily calorie budget is less than 1,200 Kcal based on your goals. It is recommended that you consume at least 1,200 Kcal/day. Please readjust your monthly weight change goal.

Your personal health coach will help you build healthy lifestyle habits. In order to provide you with more personalized resources and support, let your coach know how ready you are to make lifestyle changes.

I don't want to change.

I know I need to make changes.

I am ready to make changes in the next few weeks.

I am now taking action to make changes.

I am trying to maintain my changes.

Physical activity helps improve your overall health and fitness and reduces your risk for many chronic diseases. Select the activities below that you enjoy doing. Your coach will use this information to provide you with the right events and perfect fitness plans!

Select the types of events that interest you to receive information on local ones in your area. (Check all that apply)

Preferred Contact Method

Home Phone Cell Phone Text Message Email

Social Setting

Share your progress with your group members to stay motivated.

Note: When sharing your progress, you will be recognized under the Community - My Group section.