Figurkompass – Monatsstatus Figurkompass - Monatlicher Status Newsletter Please ensure that your details match the information on your health insurance card (so that we can correctly identify you). Questions marked with “*” are mandatory.First nameLast nameDate of birthGenderSelectFemaleMaleDiverseNo answerEmailWe're glad you're participating in the Figure Compass program. Please answer the following questions about your progress in the last month.Your current weight in kg - please round to kg, e.g. 90Has your eating behavior changed in the last month? ⭐yes, for the worse, ⭐⭐no, ⭐⭐⭐yes, for the betterja, leider zum Schlechterenneinja, zum BesserenHow satisfied are you with your weight development (in the last month)? ⭐not at all satisfied, ⭐⭐ satisfied, ⭐⭐⭐very satisfiedgar nicht zufriedenzufriedensehr zufriedenHave you incorporated more exercise into your daily routine in the last month than before? ⭐no, ⭐⭐ yes, ⭐⭐⭐yes, a lotneinjaja, sehr vielHave you been dealing with stress better in the last month? ⭐- no, ⭐⭐ can't say, ⭐⭐⭐ yesneinkann ich nicht sagenjaHave your sleeping habits improved in the last month? ⭐- no, ⭐⭐ can't say, ⭐⭐⭐ yesneinkann ich nicht sagenjaHow satisfied are you with the development of your goals in general (in the last month)? ⭐not at all satisfied, ⭐⭐satisfied, ⭐⭐⭐very satisfiedgar nicht zufriedenzufriedensehr zufriedenHave you noticed any side effects in connection with the weight loss injection? No Yes, gastrointestinal complaints such as nausea, diarrhea, vomiting, or abdominal pain and bloating Yes, headaches, fatigue and exhaustion Yes, hypersensitivity reactions Yes, hair loss OtherObesity OtherDo you have any other comments, annotations, or suggestions that have arisen in the last month?We also welcome suggestions for improving the Figurkompass that would help you.I would like to receive a copy of this form as a PDF by email (the PDF is in german, even though this questionnaire is in english for your convenience) Yes NoEmail for form submissionSignature (I hereby confirm my details) Es ist ungewohnt mit der Maus zu unterschreiben. Keine Sorge - Ihre Unterschrift ist trotzdem genauso gültig wie auf Papier. Submit
