NUTRITION CONSULTATION
Name
*
First Name
Last Name
Email
*
example: nick@dynamicfit.org
Height
*
Weight
*
Age
*
Biological sex
*
Male
Female
My main goals are focused around
*
Weightloss (Focused only on fat loss)
Muscle gain (Focused only on muscle gain)
Athletic performance (Maintain current weight w/ long and intense athletic training)
Body recomposition (Slight fat loss w/ muscle gain)
Improve health (Maintain current weight)
Other
List your specific goal and why?
How much would you like to weigh?
*
What is your goal date?
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Preferred eating style
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None
Keto
Vegetarian
Only plant based
Other
How many meals do you eat in a day?
*
Activity level in a day (Not including fitness)
*
Very light - Sitting most of the day (example: desk job).
Light - A mix of sitting, standing, and light activity (example: teacher).
Moderate - Continuous gentle to moderate activity (example: restaurant server).
Heavy - Strenuous activity throughout the day (example: construction work).
Which describes your weekly workouts?
*
Very light - Almost no purposeful exercise.
Light - 1-3 hours of gentle to moderate exercise.
Moderate - 3-4 hours of moderate exercise.
Intense - 4-6 hours of moderate to strenuous exercise.
Very intense - 7+ hours of strenuous exercise.
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