Ready questions

Copy them, adapt them to your audience and your scope. Every question below follows the rules in Write questions.

Universal core

Question	Mode	Scale or options
On a scale of 0 to 10, how would you rate your past week overall?	Linear scale	0 = terrible, 10 = excellent
On a scale of 0 to 10, how was your sleep quality in the last 7 days?	Linear scale	0 = worst possible sleep, 10 = best possible sleep
How were your energy and drive during the week?	Emojis	5 points, very low to very high
In the last 7 days, how well were you able to handle day-to-day stress?	Emojis	5 points, not well at all to very well
How did sticking to what we agreed at the last appointment go?	Single choice	4 ranked options, explanation on the worst two
On a scale of 0 to 10, how confident do you feel about keeping this up next week?	Linear scale	0 = not confident at all, 10 = completely confident
Looking back at your past week, what do you want to do differently next week?	Open answer

The confidence question deserves special attention. It measures self-efficacy, and drops in that rating usually show up before drops in adherence. It’s the earliest indicator in the set.

Nutrition

Question	Mode	Note
On how many of the last 7 days did you have your main meals as planned?	Number	0 to 7
In the last 7 days, how was your intake of vegetables and fruit?	Single choice	3+ servings/day (great), ~2/day (good), ~1/day (neutral), none (terrible)
On how many days did you hit your water goal?	Number	0 to 7
How many meals this week were outside the plan (delivery, restaurant, something unexpected)?	Number	Neutral wording, no moral word
How were your bowels in the last 7 days?	Single choice	Regular every day, most days, only a few days, didn’t work well (with an explanation)
In the last 7 days, did you feel any stomach discomfort (heartburn, burning, bloating)?	Single choice	None, mild, moderate, intense (with an explanation)
How was your hunger between meals?	Emojis	5 points, very out of control to well under control
On how many days were you able to prep food in advance?	Number	Measures the antecedent behavior, not just the outcome
In the last 7 days, on how many days was there any alcohol?	Number	Only include it if it’s an agreed goal
This week’s weight (optional)	Metric (kg)	Mark as not required

Training and physical activity

Question	Mode	Note
How many training sessions did you complete in the last 7 days?	Number	Works with zero
How was your perceived exertion in your workouts?	Emojis	5 points, very light to very intense. Here the direction is informative, not evaluative; tell the patient
Average steps per day this week	Metric (steps)	Optional
In the last 7 days, did you feel pain or discomfort during or after training?	Single choice	No, mild, moderate, severe (with a required explanation)
How was your recovery between workouts?	Emojis	5 points

Mental health and behavior

Question	Mode	Note
How was your mood for most of the last 7 days?	Emojis	5 points
In the last 7 days, how well were you able to keep up the activities that usually make you feel good?	Linear scale	0–10
On how many of the last 7 days did you practice what we agreed on (breathing, journaling, exposure, sleep hygiene)?	Number	Adjust to what you agreed
How was your contact with the people close to you this week?	Emojis	5 points
Was there anything this week you’d like to bring to the next session?	Open answer	Optional. Sets the agenda without turning into a support channel

Weekly questionnaires are not risk-screening instruments and must not be used to monitor self-harm risk. If your scope requires that, use validated instruments within an active-contact protocol, with an urgent channel defined and communicated to the patient. Never an asynchronous form with a 48-hour deadline.

Medical practice (endocrinology, psychiatry, general practice)

Question	Mode	Note
In the last 7 days, how did taking your medication as prescribed go?	Single choice	Every day, almost every day, some days, didn’t take it (with a required explanation)
Did you notice any unwanted effects in the last 7 days?	Single choice	No, mild, moderate, intense (with a required explanation)
How was the main symptom we’re treating?	Linear scale	0–10, anchored to the specific symptom
Average of this week’s readings (fasting glucose, blood pressure)	Metric	Only if the patient really takes readings
Any appointment, test, or complication this week?	Single choice with an explanation	Schedule context

Ready template: “Weekly review”

10 questions, about 2 minutes. Use it as a starting point and adapt the cycle and risk blocks to the patient.

On a scale of 0 to 10, how would you rate your past week overall? (linear scale 0–10)
On a scale of 0 to 10, how was your sleep quality in the last 7 days? (linear scale 0–10)
How were your energy and drive during the week? (emojis, 5 points)
In the last 7 days, how well were you able to handle day-to-day stress? (emojis, 5 points)
On how many of the last 7 days did you have your main meals as planned? (number, 0 to 7)
On how many days did you hit your water goal? (number, 0 to 7)
How were your bowels in the last 7 days? (single choice, 4 ranked options, explanation on the worst two)
Cycle: how many meals outside the plan happened this week? (number)
On a scale of 0 to 10, how confident do you feel about keeping this up next week? (linear scale 0–10)
Looking back at your past week, what do you want to do differently next week? (open answer)

Optional, not required: the week’s weight (metric, kg) and a progress photo (upload, biweekly).

Short variants by profession

Psychologist, 7 questions: the week overall, mood, sleep, agreed practice in number of days, stress management, confidence for the coming week, agenda for the session (open).
Personal trainer and coach, 7 questions: the week overall, sessions completed, perceived exertion, pain or discomfort (single choice with an explanation), sleep, energy, what got in the way (open).
Endocrinologist and psychiatrist, 8 questions: the week overall, medication use (single choice with an explanation), unwanted effects (single choice with an explanation), target symptom on 0–10, sleep, energy, the week’s reading (metric, optional), anything to report (open).

Fundamentals

Build

Operate

Safeguards

Universal core

Nutrition

Training and physical activity

Mental health and behavior

Medical practice (endocrinology, psychiatry, general practice)

Ready template: “Weekly review”

Short variants by profession

Next steps

Create questionnaire

Schedule sending

​Universal core

​Nutrition

​Training and physical activity

​Mental health and behavior

​Medical practice (endocrinology, psychiatry, general practice)

​Ready template: “Weekly review”

​Short variants by profession

​Next steps

Create questionnaire

Schedule sending

Universal core

Nutrition

Training and physical activity

Mental health and behavior

Medical practice (endocrinology, psychiatry, general practice)

Ready template: “Weekly review”

Short variants by profession

Next steps