NATAFIT – Projeto 100 Dias

Psicóloga Isabela Garcia

Ficha de Participantes
Nome
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Idade ________ Data Nascimento ____/ ____/ ____ Estado Civil
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Profissão
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Telefone
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Histórico Familiar de sobrepeso

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Rotina
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Doença crônica?
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Medicamento?
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Já fez tratamento psicológico?
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Pratica algum tipo de atividade
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Nível Estresse ______ O que o(a) deixa estressado(a) ___________________________
Nível Ansiedade ______ O que o(a) deixa ansioso(a)
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Nível de Sono ______ O que precisa
mudar______________________________________
Fome FÍSICA ou EMOCIONAL?
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O que faz comer mais?
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Histórico Psicológico na família?
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Como considera seu humor?
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Qual seu comprometimento com o projeto?
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EVOLUÇÃO
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