1x Macro Count OR 1x Macro Count w/ Nutritional Assessment Intake Form
This information will help me calculate your one-time macro count and get started on your nutrition plan if you elected that as well! I will send a link to schedule a 1:1 call with me for the customized nutrition plan once payment is received.
Name
First Name
Last Name
Email
example@example.com
Age
Weight
Height
Occupation
What are your goals? Fat loss? Body Recomposition? Muscle Gain?
If currently tracking, what are your macros now?
If not tracking, how many calories do you think you consume per day? (If you don't know, I would try tracking for a day or two before completing this form, as it is important to know where you are currently eating before setting your goals)
How long have you been at the above macros? (If applicable)
When was your last diet or cut phase? How long was it for?
Do you have any medical or health conditions (such as PCOS, hypo-thyroid, hashimotos, diabetes, etc)
What current medications and supplements are you taking?
How much has your weight fluctuated in the past 1-2 years?
Any recent life changes? Be as detailed as possible. (ie postpartum, breast feeding, diagnoses, stressful life events)
Are your hormones/ cycle regular, if applicable?
What are your energy levels like- scale of 1-10?
How is your digestion? Normal bowel movements? Bloating/ gas?
What is your activity like? How many days a week do you workout and for how long?
How many days do you strength train?
How many days do you do cardio?
What is your average daily step count?
How many hours a day do you sit?
Give me an example of the last 2 days of your eating (or a normal full day of eating for you).
Anything else you want to add/ think I should know?
Please use the payment link below. Once payment is received, your custom macro count will be delivered within 2-5 business days.
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1 X Macro Count
$
90.00
Quantity
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1 X Macro Count + Nutrition Assessment
$
150.00
Quantity
1
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10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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