Weekly Check-In Template for Fitness for Diabetes Management Coaches

Use in FirstRep form

Personal Information

Collect essential data to tailor fitness plans for diabetes management.

Aa Name *

Enter your full name

# Age *

Enter your age

v Type of Diabetes *

Current Medications

Understanding medication is crucial for safe exercise planning.

... List your medications *

Include dosage and timing

# Last insulin dose (if applicable)

Enter hours ago

Exercise History

Review past exercise experiences to identify preferences and concerns.

... Previous exercise routines *

Describe your past workouts

Y/N Any previous injuries? *

1-10 Fear of exercise *

Rate your fear of exercise

Blood Sugar Monitoring

Document blood sugar levels to assess patterns during exercise.

# Typical fasting blood sugar (mg/dL) *

Enter your fasting level

# Blood sugar before exercise (mg/dL) *

Enter your level before workouts

# Blood sugar after exercise (mg/dL) *

Enter your level after workouts

Exercise Goals

Establish clear and achievable exercise targets.

v Primary fitness goal *

# Weekly exercise frequency *

Number of days per week

vv Preferred types of exercise *

Post-Exercise Check-In

Assess how clients feel after workouts to adjust plans accordingly.

... Physical feelings post-workout *

Describe how you feel

# Blood sugar post-exercise (mg/dL) *

Enter your level after workouts

Y/N Any hypoglycemia symptoms? *

Coordination with Healthcare Team

Ensure alignment with healthcare providers to manage diabetes effectively.

Aa Healthcare provider contact *

Enter provider's name and contact

D Recent consultation date *

... Notes from healthcare provider

Any recommendations or concerns?

Why Use This Template

Promotes accountability

Regular check-ins help clients stay committed to their fitness journey.

Enhances safety

Monitoring blood sugar levels reduces the risk of hypoglycemia during exercise.

How to Use

Fill out the personal information section before each week's workout.

Review the exercise history and blood sugar monitoring sections to adjust plans.

Customization Tips

Add personal anecdotes to make the template relatable.
Include specific exercises your clients enjoy.
Adjust blood sugar monitoring frequency based on individual needs.
Incorporate motivational quotes to inspire clients.
Use color coding to highlight important sections.

Build and send fitness for diabetes management templates digitally with FirstRep. Free for up to 3 clients.

Start for Free See All Features

Frequently Asked Questions

How often should I check my blood sugar during workouts?

It's recommended to check blood sugar before, during, and after workouts, especially if you are on medication.

What if I feel symptoms of hypoglycemia?

Stop exercising immediately, consume fast-acting carbohydrates, and monitor your blood sugar.