Show Up With Grace Macro Coaching
Custom Macro Count Questionnaire (Group Coaching)
Name
First Name
Last Name
Email
example@example.com
Gender:
Male
Female
Age
Height
Weight
Let’s start with getting to know YOU! Tell me a little about yourself - Where do you live? What do you do for work? Do you have kids? Married? In school? Do you work nights? Are you an avid traveler? What are your hobbies/how do you spend your free time? I genuinely want to get to know you, and what your life looks like!
What is your initial goal?
Maintenance
Fat loss
Surplus/bulk
Current Fitness regimen: Including cardio/weights. How many times per week and duration? How long have you been consistently doing this schedule? PLEASE be as detailed and specific as possible!
How many steps do you get daily on average?
Current nutrition regimen: Again, as detailed as possible. If you know what your macros are currently, please share them. What does each meal typically look like for you? (Honesty please):
What is your biggest pain point when it comes to nutrition? (Ex: consistency, protein, drinking enough water, etc.):
How many ounces of water do you think you drink a day?
Do you have any underlying health conditions?
How often have you dieted for weight or fat loss over the last 5 years?
Current supplementation if applicable:
Food allergies:
Any dietary restrictions (vegan, vegetarian, GF, DF, etc) or food allergies?
How many hours of sleep do you typically get?
Walk me through a day in the life (during the week) with your work/fitness/kid/family schedule:
Are you currently...
Pregnant?
Nursing?
Trying to conceive?
What are you hoping to gain & learn from this group? What will be helpful for you to see more or less of?
Anything else you'd like me to know?
By completing this application, you are in agreement that you are 18 years of age or older. You understand that this is a preliminary application and not an agreement to coaching, and that no coaching program will begin until a payment is successfully processed. You acknowledge that Grace Terbrock is a certified nutrition coach, and is not a physician or a registered dietician. This program and advice should not be taken as medical advice. It is not intended to diagnose, treat, care, or prevent any health problem - nor is it intended to replace the advice of a physician. Always consult your physician or qualified health professional before starting a new diet program. By participating in this program, you accept full responsibility for your actions.
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