New Client On-boarding Intake

Assessment and questionnaires. Due 4 days prior to kick-off call!
add body-fat% if you have that info!

Food Preferences

Please list in details what you love & enjoy to eat. Even if it does not “sound” healthy! All of your fav foods! When you get to the macro portion- select everything you currently eat and would be open to trying!
Select ALL that apply
sweet potatoes, quinoa, brown rice, tortilla…
Example: avocado, olives, cheeses, coconut oil, peanut butter..
Include beverages
Example: goat cheese, greek yogurt, oat-milk…
Example: Pakistani/Indian, Mediterranean, Asian, African…
Example: Non-alcoholic (coffee, fresh juices, tea, smoothies) & Alcoholic
Honesty please!
Cafes & Restaurants. You’ll have the opportunity to add to this list.
Select ALL that apply
Links to store website is appreciated!
For the week
Examples; Snap Kitchen, Hello Fresh
Example: Knee pain, lower back pain..etc
Click or drag files to this area to upload. You can upload up to 5 files.
Click or drag files to this area to upload. You can upload up to 10 files.
Example: Protein powders, vitamins, prescriptions..
optional
Example; Orange Theory, Lifetime Fitness, La Fitness, Apartment Gym..
Example: Strength training 3x week, cycling 2x week, Light walking daily, or sitting in a desk all day. Goals: aim for training 3 times a week.
Example; reading a book, talking to family, praying, meditation..
Example: Apple watch, Fitbit, Amazon

Current Energy/Macro Intake (IMPORTANT)

Track 3-4 days of your intake. Preferably 2 week days, and 2 weekend days. Use the “save & resume later” button as you track days before submitting.
Example: Breakfast: 2 eggs + 1 cup cooked oatmeal + 1 banana, Lunch: brown rice pasta + 4 oz or hand size chicken breast + vegetables, Snacks: Vega protein bar
Example- Breakfast: skipped, Lunch: Burger & Fries from hopdoddy…
ANYTHING you think would help with the program design process.
Select any/all options that work best for you! Weekly calls are scheduled on the same day EACH week for 45 mins. (12 total sessions)

Health is the soul that animates all the enjoyment of life, which fade and are tasteless without it.

Seneca