New Enquiry Information for 1:1 Diet

New Enquiry

Ellie Achitei: Trusted Consultant
A little bit about you

Please answer the questions below so I can best support you in achieving your goals. Once complete, I’ll arrange a video call for your first consultation at a time that suits you.
Name*

First NameLast Name
Email*
example@example.com
Phone Number *
Address*

House Number & Street Address

Street Address Line 2

City/CountyState / Province

Postcode
Date of Birth*

DayMonthYear
Date
Lifestyle and Medical

These answers help me to recommend the best plan for your journey
Please Enter your Height*
Please enter your approximate Weight*
Please enter your waist measurement
Your Occupation
Please indicate your level of Activity
Do you take any prescribed medication at all? If so please give names and dosage. *
Do you have any ongoing medical conditions? If so, please give details*
Do you have any allergies or intolerances? If so, please give details*
Have you had any general accidents or any surgery in the last 3 months?*
Women only: have you given birth in the last 3 months?*
Women only: are you currently breastfeeding?*
Have you followed The 1:1 Diet plan before?*
NOTE: The 1:1 Diet by Cambridge Weight Plan is NOT appropriate for those who are alcoholic, substance misusers, underweight, pregnant, breastfeeding, or who have given birth in the last 3 months, and those younger than 14 years.
Use this space to note anything else you think I should know or if you have any questions ahead of your appointment.
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New Enquiry

A little bit about you

Lifestyle and Medical