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First name
Last name
Email
Phone
Birthday
Month
Month
Day
Year
Address
What is your current weight?
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How would you describe your overall health today?
Can you describe your living environment? Do you have access to places to walk nearby?
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Do you have access to resistance training equipment or a gym? Please describe.
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Describe your sleep environment: • Do you sleep alone or with a partner? • Does a pet (e.g., a dog) sleep in your bed? • Is your room dark/black or over-lit at night? • Do you have access to fresh air or airflow in your room?
What are your top 1–3 goals for the Brae 100?
If this program worked beyond your expectations, how would your life look different in 100 days?
Why is this important to you now?
Do you have any current or past injuries or physical limitations I should be aware of?
Are there any movements or exercises you are avoiding due to pain or concern?
How would you describe your current fitness level (e.g., sedentary, somewhat active, athlete)?
What types of physical activities or sports have you enjoyed in the past?
Do you walk regularly? If so, how far/how often? Do you walk alone or with others?
Have you ever been diagnosed with any medical conditions?
Are you currently taking any medications or supplements?
Have you experienced any of the following in the past 6–12 months?
Have you been told you have: High blood pressure, High cholesterol, Insulin resistance, Hormone imbalance?
Describe a typical day of eating for you.
Do you follow any particular dietary style?
Do you regularly consume soda, caffeine, alcohol, nicotine or other substances?
How many hours of sleep do you get each night? Do you feel rested when you wake?
How would you rate your daily stress level, from 1 (low) to 10 (high)?
How do you currently cope with stress?
How much water do you drink daily, and how is it typically filtered or sourced?
Do you believe change is possible for you right now? Why or why not?
What are your biggest doubts or fears about doing the Brae 100?
Are you doing this more because you are running from something, or moving toward something?
Are you satisfied with the direction of your life, or are you seeking a new path or deeper fulfillment?
What are you most proud of in your life so far?
What do you feel is still missing or unresolved?
. Do you believe in God, a higher power, or some form of spiritual presence?
What does the word belief mean to you? Where does it show up in your life today?
Do you have a faith practice, spiritual rhythm, or ritual of reflection?
What does forgiveness mean to you? Who or what comes to mind when you hear that word?
Do you feel that hope is something you possess, something you seek, or something you’ve lost?
How would you define hope, in your own words?
Who in your life is supportive of your desire to improve your health?
Are there people, places, or habits that may be holding you back from progress?
Do you have access to nature, trails, or peaceful outdoor spaces?
Do you live near a gym, pool, or walking path? Would you benefit from a simple home setup for training and recovery?
Are you ready to go ALL IN?
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