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TYPICAL DAY

To the best of your ability, what does your food intake look like in a typical day? We get it not days are always the exact same but if you had to say on average. Judgement free zone, try to be as honest as possible, use yesterday as your example.
Do You Currently Eat 3 Meals A Day?
If no, which meal(s) get skipped?
What Time Do You Wake Up
What is the first thing you consume and what time.
ex Coffee at 7am or Bagel and Cream Cheese at 645am
What is the next thing you consume and what time.
ex Orange with water at 10am
What is the next thing you consume and what time.
ex Lunch - soup with crackers with tea at noon or I often skip this because I am too busy.
What is the next thing you consume and what time.
ex Snack - protein bar at 2pm or Coffee and muffin at 2pm or I don't have anything
What is the next thing you consume and what time.
ex Dinner - meat, potatoes and veggies and a glass of wine at 6pm
What is the next thing you consume and what time.
ex Chips at 740pm or I don't eat anything after
Any additional meals or notes in regards to nutrition for the day or habits.
What time is bedtime typically.
Daily I have blanks cups of water.
Daily I have blank coffees.
Daily I have blanks cups of tea.
Daily I have blank glasses of juice.
Daily I have blanks pops.
Daily I have blank energy drinks.
Daily I have blanks beers/wines/spirits.
Daily I have blank glasses of milk.
Do you have any food allergies, if so please include.
Do you have issues with Gluten?
Any other dietary or things you avoid I should know?

Do you workout? Or want to workout?

Other
How committed are you to change your lifestyle?
Where are you located?
Would you be interested in in person weigh ins at the Pulse Nutrition in Penetanguishene?
Yes/No
Would you be interested in being an ambassador & receive a discount for life?
Yes/No
Have you tried Herbalife before?
Yes/No
Do you know anyone else who might be interested in taking part in the challenge/trial with you? If so indicate a contact method for them and name or feel free to loop us in a conversation via Facebook or Email deannalilianpalazzo@gmail.com
Should be Empty:

Becoming the healthiest version of our selves in mind, body and soul!

TYPICAL DAY