Well-Being Assessment

Hello and Welcome to ACAC Fitness and Wellness!

Together with Wellcoaches, ACAC Fitness and Wellness has created this well-being assessment to help you and your coach evaluate the effectiveness of your coaching program and your progress, before you start work with your coach, and if appropriate, 6 months and 12 months later.

After you complete the assessment, we will estimate your Well-being Score to show how you are doing overall and in eight areas:

  1. Life satisfaction
  2. Energy
  3. Exercise
  4. Nutrition
  5. Weight
  6. Mental & emotional fitness
  7. Health

Your well-being assessments will be archived on your private and confidential coaching website. You will choose your username and password and can change it or inactivate the site when you wish (email techsupport@wellcoaches.com).

You and your coach can review your well-being assessments for up to 36 months. Please click to review our privacy and confidentiality policy.

Before completing the well-being assessment please download the most up to date version of Flash Player at www.adobe.com. After downloading please be sure to restart your computer.

MY AGREEMENT OF RELEASE OF LIABILITY

In consideration of my being allowed to receive coaching services from a certified wellness coach, and, in that process, to be coached in fitness, nutrition, weight management, stress management, mental health, and/or health risk management, I do hereby waive, release, and forever discharge my coach and Wellcoaches Corporation and ACAC Fitness and Wellness Centers, Inc.,  its officers, agents, independent contractors, employees, representatives, executors, and all others from any and all responsibility or liability for injuries or damages resulting from my participation in any activities or my use of fitness equipment arising out of my participation in any activities under such coaching.

I do also hereby release all of those mentioned and any others acting upon their behalf from any responsibility or liability for any injury or damage to myself, including those caused by the negligent act or omission of any of those mentioned or others acting on their behalf or in any way arising out of or connected with my participation in any activities of wellness coaching.

I understand that as a part of my wellness coaching program, I may be coached to, or it may be suggested that I, participate in exercise activities, e.g., exercise, aerobic training, strength training, flexibility training, etc., that could be potentially hazardous. I also understand that such activities involve risks of injury and even death, and that I am voluntarily participating in these activities and using equipment and machinery with knowledge of the dangers involved. I hereby agree to expressly assume and accept any and all risks of injury or death.

I further understand that my certified wellness coach, as applicable, is an independent contractor and not an agent of Wellcoaches Corporation or ACAC Fitness and Wellness Centers, Inc.

I do hereby further acknowledge that I have either had a physical examination and have been given a physician's permission to participate or that I have decided to participate in activity and or use of equipment and machinery without the approval of my physician and do hereby assume all responsibility and risks of injury or death from such participation and activities.

I accept the above agreement of release of liability and the terms of the well-being assessment.

I don't accept

Print Agreement of Release of Liability