MACRO QUESTIONNAIRE
Embrace You Fitness Challenge 2023
Name
*
First Name
Last Name
Email
*
example@example.com
Age
*
Years
Sex
*
Male
Female
Heigh converter
Height (cm)
*
cm
Goal
*
Lose weight
Build as much muscle as fat is burnt, weight stays the same
Gain lean weight/muscle
Daily Activity Level (not including workouts)
*
Please Select
Sedentary (ie: desk job)
Moderate (ie: on feet alot)
Active (ie: construction worker)
How many steps do you average per day?
*
How many days do you workout at home or in the gym?
*
How many minutes per day do you workout?
*
What category would you describe your workout day?
*
Please Select
Light Activity (200-400 calories burned)
Moderate Activity (400-600 calories burned)
Very Active (650+ calories burned)
How would you describe your workout intensity?
*
Please Select
Casual
Moderate
Vigorous
What is your current diet like?
*
Be as specific as possible. This is VERY important. DO NOT LEAVE BLANK.
What is your current calorie intake like?
*
If you don't know your current calorie intake, track a normal day of eating to get an estimate. This is VERY important. DO NOT LEAVE BLANK.
Have you counted macros before? If so when? And what are/were your macros?
*
If you don't know your current calorie intake, track a normal day of eating to get an estimate. This is VERY important. DO NOT LEAVE BLANK.
Do you have any history of eating disorders?
*
This is totally confidential, but pertinent.
Any medical limitations? (ie: Diabetes, auto immune disorders)
*
This is totally confidential, but pertinent.
Is there anything else I should know about you?
*
This is totally confidential, but pertinent.
Anything specific you'd like to learn the the Nutritional Seminar?
*
The topic may be touched on.
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