Disclaimer
The information provided in this Intake Analysis questionnaire is intended for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. The results of this analysis should not be used to diagnose or treat any health condition or illness without consulting with a qualified healthcare provider.
Please note that the recommendations provided based on this questionnaire are general in nature and may not consider all individual factors such as underlying health conditions, allergies, or specific nutritional needs. It is important to consult with a licensed dietitian, nutritionist, or healthcare provider before making any significant changes to your diet or lifestyle.
By completing this questionnaire, you acknowledge that the information provided is accurate to the best of your knowledge and that any decisions you make based on the results are your responsibility. The person or entity providing this questionnaire is not liable for any adverse effects or consequences resulting from the use of the information provided.
If you have any concerns about your health or diet, please seek the advice of a qualified healthcare professional. ALL THE INFORMATION I HAVE GIVEN IS CORRECT
All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.