Nutrition Guidelines Form

Name* This field is required.

First Name

Last Name

Email* This field is required.

example@example.com

Would you like a meal plan filled with interesting recipes or a simple easy to follow outline?

Rotating Plan with Fun & Interesting Recipes

Rotating Plan with Quick & Simple Recipes

Rotating Plan with a Mixture of Quick Recipes & More Complex Recipes

Simple Outline with Portions & Ingredient Substitutions

How many unique recipes would you like each week1 = 1 unique recipe per week per meal that repeats each day. 7 = 7 unique recipes per week per meal, no repeats

Do you prefer to make your own snacks or purchase store made snacks?

Make my own healthy snacks

Purchase premade snacks

A mixture of the two

Do you like integrating protein shakes into your meal plan?

Always

Sometimes

Never

Do you request or require a specific diet type?* This field is required.Well-Choices promotes eating a healthy, well-balanced diet to avoid nutrient deficiencies. Well-Choices will create meal plans based on the client's dietary needs or requests but does not endorse any specific diet type.

I Prefer a Balanced Diet

DASH Diet

low-FODMAP

Mediterranean

Pescatarian

Vegan

Vegetarian

Other

Blood Type Diet: What Is Your Blood Type

You selected "Other" as your requested or required diet type. Please explain the diet type you would like to follow

Do you have any of these common food allergies?

Dairy

Egg

Fish

Gluten

Peanuts

Shellfish

Soy

Tree nuts

Other

List all of your food allergies

How would you like to identify the ingredients or foods you want to be EXCLUDED from your meal plan?

Simple

Advanced

List all ingredients or foods you want EXCLUDED from your meal plan

Fruit: Select all ingredients that need to be EXCLUDED from your plan.

Apple

Apricots

Avocado

Banana

Blackberries

Blueberries

Cantaloupe

Cherries

Cranberries

Dates

Grapefruit

Grapes

Honeydew melon

Kiwi

Lemon

Lime

Mango

Melon

Orange

Papaya

Passion fruit

Peaches

Pear

Pineapple

Plantain

Plum

Pomegranates

Prunes

Raisin

Raspberries

Red currants

Strawberries

Tangerines

Watermelon

Vegetables: Select all ingredients that need to be EXCLUDED from your plan.

Acorn squash

Artichoke

Asparagus

Beets

Bell pepper

Broccoli

Brussel sprout

Butternut squash

Cabbage

Carrots

Cauliflower

Celery

Chili peppers

Chives

Collard Greens

Corn

Cucumber

Eggplant

Garlic

Ginger

Green beans

Green onions

Green peas

Greens

Kale

Kohlrabi

Leeks

Lettuce

Mushroom

Mustard greens

Olives

Onion

Parsnips

Pickles

Portobello mushroom

Potato

Pumpkin

Radish

Red cabbage

Red onion

Rhubarb

Romaine lettuce

Rutabagas

Sauerkraut

Scallions

Shallots

Shiitake mushrooms

Snow peas

Spaghetti squash

Spinach

Squash

String Beans

Sugar snap peas

Summer squash

Sun-dried tomatoes

Sweet peas

Sweet Potato

Tomato

Turnip greens

Turnips

Watercress

White button mushrooms

Winter squash

Yams

Yellow Squash

Zucchini

Grains: Select all ingredients that need to be EXCLUDED from your plan.

Barley

Brown rice

Buckwheat

Grains

Noodles

Oatmeal

Pancakes

Rye

Wheat bran

Wheat germ

Quinoa

White bread

Whole wheat bread

Wrap

Meat-Based Protein: Select all ingredients that need to be EXCLUDED from your plan.

Bacon

Beef

Bison

Chicken

Egg

Ham

Lamb

Pepperoni

Pork

Roast beef

Sausage

Steak

Turkey

Turkey Bacon

Veal

Vegetable-Based Protein: Select all ingredients that need to be EXCLUDED from your plan.

Black Beans

Edamame

Falafel

Garbanzo beans

Kidney beans

Lentils

Lima beans

Navy beans

Red beans

Soy

Tofu

White beans

Shellfish: Select all ingredients that need to be EXCLUDED from your plan.

Calamari

Clams

Crab

Eel

Lobster

Mussels

Octopus

Oysters

Scallops

Shrimp

Snail

Fish: Select all ingredients that need to be EXCLUDED from your plan.

Catfish

Cod

Flounder

Halibut

Herring

Pollock

Salmon

Sardines

Sea Bass

Swai

Tilapia

Trout

Tuna Fish

Swordfish

Seeds/+: Select all ingredients that need to be EXCLUDED from your plan.

Chia Seed

Chocolate

Coconut

Flax Seed

Pesto

Pumpkin seeds

Sesame seeds

Sunflower seeds

Tree Nuts: Select all ingredients that need to be EXCLUDED from your plan.

Almonds

Brazil nuts

Cashews

Chestnuts

Hazelnuts

Hickory nuts

Macadamia nuts

Pecans

Pine nuts

Pistachios

Walnuts

Dairy: Select all ingredients that need to be EXCLUDED from your plan.

Cheese

Cottage cheese

Greek yogurt

Milk

Yogurt

Seasonings/+: Select all ingredients that need to be EXCLUDED from your plan.

Basil

Bbq sauce

Cilantro

Cinnamon

Clove

Coffee

Curry

Dill

Fennel

Guacamole

Honey

Hummus

Jalapeno

Ketchup

Liquid Aminos

Mayo

Mustard

Nutritional Yeast

Oregano

Paprika

Parsley

Pepper

Peppermint

Pumpkin spice

Rosemary

Sage

Salt

Seaweed

Soy sauce

Sugar

Sweet Chili sauce

Tahini

Thyme

Turmeric

Vanilla

Vinegar

Wasabi

Are there any other notes or requests you would like to add?