1 Hour Consultation Questionnaire

1 Hour Consultation Questionnaire

Please complete these questions with as much detail as possible. After you submit this questionnaire, I'll reach out to schedule your 1-hour personalized consultation. During our consultation, be prepared to dive into your dieting history, health and wellness goals, current nutrition and fitness routine, and more. All consultations come with a PDF recap of our conversation which will include your custom macro calculations, my nutrition recommendations for you, nutrition topics, food lists, and more. You'll receive this custom 15+ page guide within 48 business hours after our call. I look forward to speaking with you!
Personal Information
Name*
Email*
Phone Number
Gender*
Preferred Pronouns*
he/him, she/her, they/them
Age*
Height (inches)*
Weight (lbs)*
What is your occupation?*
Do you have any current injuries or medical conditions?*
Goals and Challenges
What are your health and wellness goals?*

Lose weight/inchesIncrease muscle massLifestyle changeCreate healthy food choices
Think about your ideal future self in 2 years. How do you feel? What do your days look like? What do you look like? What's important to you? *
What is your biggest nutritional challenge?*

Dislike cooking or don't know how to cookDon't know what I should eatWine/alcoholTime to prepare mealsLarge portionsEating out frequentlySweet toothEating quicklySnacking when not hungryCravingsLack of planningEmotional/stress eatingFamily or peer pressureOther
Activity
How many hours do you sit during the day?*
How many steps do you take per day?*

0-4,0004,000-6,0006,000-8,0008,000-10,00010,000 +Not sure
How many hours of cardio do you complete per week? What type of cardio?*
How many hours of strength training do you complete per week? What type of strength training?*
Nutrition and Routine
Have you tracked your food or macros before?*
If you currently track your macros or calories, what are your current macro or calorie targets?*
Are you a vegetarian or vegan?*
Do you have any food intolerances, allergies, or special preferences?*
Please describe your current nutrition regimen. Be brutally honest with what you're doing currently - not where you hope to be. No judgement here!*
What tactics have you tried in the past to improve your nutrition? What has worked? What didn't?*
Have you dieted for weight loss in the last 2 years? If yes, what diets? How many calories were you eating? How long did that last? Please be as detailed as possible.*
Have you ever been diagnosed with an eating disorder or struggled with an undiagnosed eating disorder?*
Do you currently:*

Meal PrepMeal PlanUse Meal Prep ServiceWing it
Describe your meal prep and/or meal planning:*
How many time a week do you drink alcohol?*

0-11-22-34 +I don't drink alcohol
Stress Management
Do you have daily or weekly self-time dedicated to just you?*

YesNo
What things in your life make you happy? What activities charge your battery?*
Let's Go!
What do you hope to leave this consultation with?*
Is there anything else you would like me to know? What specific questions do you have for me?*

My Products

Cindi Stickle

1-Hour Consultation, Macro Calculations, Recap PDF

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1 Hour Consultation Questionnaire

Personal Information

Goals and Challenges

Activity

Nutrition and Routine

Stress Management

Let's Go!