Welcome

1
Name
First Name
Last Name
2
Email
example@example.com
3
Phone Number
Please enter a valid phone number.
4
Instagram Handle eg. @mikaelaaking
5
Age
6
Height & Weight
7
What are your current goals? What are you hoping to achieve working with me?
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Ok
8
Tell me about yourself
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9
What does a typical day of eating look like for you? Current calories if known?
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10
Do you have any food allergies/ intolerances
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Ok
11
What foods do you love eating? any foods you dislike?
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12
Do you have any medical conditions that i may need to be aware of that may influence your ability to follow a diet or exercise?
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13
Are you on any medication? If so please list (Please be transparent, as there are food/drug intolerances that may be important for me to note, especially for meal plans).
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14
What is your occupation?
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15
Select your average daily activity levelSedentary-(0-5000 steps a day) Lightly active- (5000-10,000 steps a day), Active -(10,000 + steps a day) Labour intensive (10,000 + steps or Labour-intensive job)
Sedentary
Lightly Actie
Active
Labour Intensive
16
What is your average daily step count?
17
How much sleep do you get on average per night?
18
Briefly describe your relationship with food and the scales?
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19
What day of the week would you like to do your check in, involving photos and measurements?
Monday
Tuesday
Wednesday
Thursday
Friday
20
Any other additional information you would like to provide?
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