1x Macro Count and Nutrition Consultation.

1x Macro Count and Nutrition Consultation.

This form is for a 1x Macro Count and Nutrition Consultation. Complete the form with as much detail as possible so I can prepare for our consultation call, provide a customized macro count with a personalized course of action. A recap email will be sent within 5 business days with customized macro count (based on goals, diet history & current exercise routine), periodization suggestions, nutrition audit and tracking tips.
Name*

First NameLast Name
Email*
example@example.com
Confirm Email*
example@example.com
Age*
Height (example: 5'7)*
Current Weight (lbs)*
Sex (assigned at birth)*
Full Macro Profile (protein, fats, carbs & calories)Protein + CaloriesBalanced Plate & Better Nutritional HabitsAll of ThemI Am Not Sure
Yes! I love it!Yes, but not consistentHere & ThereNever! Newbie here!
If you are currently tracking? What are your goals? What are your current macros and calories set to?*
Weight LossFat LossBuild Strength/MuscleBuild Healthy HabitsCreate Sustainable HabitsImproved Relationship With Food
What is your BIGGEST hurdle getting in the way of reaching your goals?*
Less than 3 years3-6 months6 months - 1 yearOver a year agoHaven't been dieting
What diets or programs have you tried in the past? Where they successful? Why or why not?*
Tracking Full Macro ProfileOnly Tracking Protein + CaloriesFocused on Balanced Plates and/or ModerationWinging itEat out oftenEat three meals a dayEat under a certain amount of caloriesFollow a low carb or Keto dietSkip meals
Provide any details about your current NUTRITION? (types of food, any allergies, dietary restrictions, dislikes, how often you eat, meal prep, delivery meal services, have to plan and cook for family, etc)*
Do you have support systems to help you reach your goal? This is often an overlooked question, but important. Please explain no matter if yes or no.*
SedentaryLightly Active (1-3 days a week + under 10k daily steps)Light/Moderately Active (2-3 days + 10k daily steps+)Moderately Active (3-6 days + 10k daily steps+)Very Active (6-7 days + 10k daily steps+)Extremely Active (5-6 days even 2x a day + 10k daily steps+)
Cardio OnlyStrength/Weight LiftingCardio + Weight LiftingYoga, Pilates, BarreHITT Cardio ClassesLong WalksOnly Daily StepsNothing, Really.
Provide any details about your exercise routine (how many days a week, duration, twice a day, at home, in gym, etc)*
Are you currently tracking your daily steps? If Yes, provide daily average.*
Do you track water? If Yes, how much do you aim for a day?*
How is your sleep quality? On average how many hours do you get per night?*
Do you have any injuries (past or present) or surgeries/health conditions to note (PCOS, gastric bypass, hysterectomy, hypothyrodism, IBS, etc)*
YesNoN/A
Any other information or questions you would like to include to help me best prepare for our consultation call?*
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1x Macro Count & Nutrition Consultation
Price includes a 1-Hour consultation call, one time macro count (based on current goals and diet history), suggested periodization timeline, nutrition audit, tracking tips and a personalized course of action. Customized count with recommendations are sent via email in PDF form within 5 business days from the consultation call. All sales are final. No refunds.

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