The Macro Doctor Intake Form

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Phone Number (for group coaching if applicable)
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Age*
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Please describe your current physical activity level including average daily steps?*
Please describe your current eating habits*
Please describe your dieting history (age started, chronic dieting, disordered eating etc)*
Please tell me about your goals. Include if you are wanting to start losing fat or focusing on body recomposition. *

My Products
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Macro Count & Macro Manual
One time macro count and The Macro Doctor Macro Manual to teach you how to count macros!

$50.00



Macro Count with cut AND maintenance numbers & Macro Manual
One time macro count with cut AND maintenance numbers and The Macro Doctor Macro Manual to teach you how to count macros!

$60.00 Quantity



Macro Count with cut AND maintenance numbers & Macro Manual PLUS 1 hour private session
One time macro count with cut AND maintenance numbers and The Macro Doctor Macro Manual to teach you how to count macros! Plus a 1 hour private education session with coaching!

$150.00 Quantity



Macro Count with cut AND maintenance numbers & Macro Manual PLUS 3 months of coaching access via GroupMe
One time macro count with cut AND maintenance numbers and The Macro Doctor Macro Manual to teach you how to count macros! Plus 3 months of group coaching in the GroupMe ap!

$150.00 Quantity



Add on: One hour private coaching and/or education
Available anytime: 1 hour of private coaching with me to ask any questions, get coached through roadblocks, or further your macro learning!

$125.00 Quantity



Additional Group Coaching-1 month
$35.00 Quantity



Addiitonal Group Coaching-3 months
$100.00 Quantity



Reverse Diet Manual
Learn how to execute your reverse diet so you can return to maintenance without regaining the weight you have lost!

$20.00 Quantity



Total

$0.00
I am not a licensed nutritionist. In no way should the information provided by The Macro Doctor be considered medical advice, and at all times the advice of YOUR medical professional should supersede recommendations from The Macro Doctor. The Macro Doctor assumes the information contained in the nutritional coaching program is provided for informational purposes only and is not meant to act as a substitute for the advice provided by your own physician, or other medical professional. Only you and your doctor can determine what is healthy, right or safe for you. Clients who fail to consult their physician(s) prior to starting a diet or exercise program expressly assume the risk of any adverse effects. None of the information provided by The Macro Doctor is intended to be a treatment protocol for any disease or medical condition, but rather is offered to provide information, choices and suggestions regarding nutritional and diet support. Please consult your own physician or health care provider about the applicability of any opinions or suggestions with respect to your own symptoms or medical conditions, if they exist. The Macro Doctor shall not be liable for damages arising out of or in connection with the use of my services. These services are not intended to diagnose, treat, cure or prevent any disease. Use of the nutritional information provided by The Macro Doctor is at the sole choice and risk of the client. The Macro Doctor is not responsible, nor liable, for any harm or injury resulting from the use of the information provided by The Macro Doctor. Always consult your doctor before making any changes to your exercise, diet or nutrition program. If you choose not to obtain the consultation, advice and consent of your physician while using any information provided by The Macro Doctor, you are agreeing to accept full responsibility for your actions. The Macro Doctor is committed to the privacy of its clients and all of their personal information, data and images. I have read and fully understand the need for me to consult with my own medical practitioners prior to beginning this or any new program. Further, I release and indemnify The Macro Doctor from any and all claims arising out of my use of The Macro Doctor services. You have selected this service by your own informed choice.*

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