Please answer honestly — this is not about perfection. This helps us identify patterns, celebrate wins, and adjust support where needed.General Check-InNameDateHow would you rate this week overall?AmazingPretty goodMixedRough weekSurvival modeSymptoms + ProgressWhat symptoms are improving?What symptoms are staying the same?What symptoms are getting worse or flaring?Any new symptoms or changes?Wins + ChallengesWhat is going well right now?What feels like it’s flopping or hard to stay consistent with?What habits felt easiest this week?What habits felt most difficult?Energy + MoodHow has your energy been this week?Consistently goodUp and downMostly lowExhaustedHow has your mood been?StableEmotionalAnxiousIrritableOverwhelmedLow/depressedStress level this week:LowModerateHighVery highCycle + Body AwarenessWhere are you currently in your cycle?Any noticeable cycle-related symptoms?Have you noticed any patterns related to: Food? Stress? Sleep? Movement? Your cycle?Nutrition + LifestyleAre you eating consistently?How is hydration?How is sleep quality?How is movement/exercise feeling?Anything your body is craving more or less of?ReflectionWhat are you most proud of this week?What support do you feel you need most right now?Is there anything you want me to focus on during our next check-in?SubmitSave as DraftPlease do not fill in this field.
