KAD One-Off Nutrition Review: Client Insight Form

KAD One-Off Nutrition Review: Client Insight Form
This form helps me better understand your current nutrition habits, routines, and any challenges you’re facing. There’s no right or wrong - just honest answers that help me provide meaningful, personalised feedback to support a healthier, stronger future.
Personal & Contact Information
Name*

First NameLast Name
Email*
example@example.com
Date of Birth*

MonthDayYear
Occupation*
Body Weight (kg) - if known
Height (cm) - if known
Hip Circumference (cm) - if known
Resting Heart Rate - if known
If you use a fitness tracker, your RHR will be in the app. Or, take your pulse (neck or wrist) for 30 seconds, then double it. This helps me assess your recovery, stress levels, and overall cardiovascular health.
Blood Pressure - if known
If you’ve had your blood pressure taken recently (doctor, chemist, gym), please enter it here. Otherwise, leave blank.
Health History
Have you had a general medical check-up in the last 12 months? - If yes, please elaborate on concerns raised.*
Are you currently taking any prescribed medications or supplements? - If yes, please list.*
Do you drink alcohol? If so, how often and roughly how much?*
Do you currently have or have a history of any of the following medical conditions (Tick all that apply)*

Type 1 DiabetesType 2 DiabetesHigh Blood PressureHigh cholesterolPCOSCardiovascular diseaseMental health condition (e.g anxiety, depression)None of the aboveOther
Have you or a close family member had any of the following?*

Heart attackStrokeAnginaType 2 DiabetesHigh blood pressureNone of the aboveOther
Nutrition Habits & History
Do you currently track your food? If so, what method/app do you use?*
If you have tracked in the past, what method/app did you use?
What is your relationship with food like right now?*
Do you notice yourself turning to food during times of stress, boredom, or emotion?*
Do you ever feel guilty after eating off-plan?*

NeverRarelySometimesAlways

On average, how many meals per week are… *

	Number of meals
Home-cooked by you
Cooked by someone else
Eaten out or ordered in

Any foods you dislike or avoid?*
What do you feel has made it hard to improve or maintain your nutrition habits in the past?*
How did you hear about KAD Fitness?*
Is there anything else you'd like to share with me? Any questions?
What Happens Next:

After submitting this form, you’ll be taken to a payment page to finalise your Nutrition Review.

Once I’ve received both your form and payment, I’ll email you a personalised 3-Day Food Diary to complete (within 24–48 hours). This helps me understand your current habits so I can tailor your feedback properly.

Once that’s submitted, I’ll begin your review and follow up with detailed, practical feedback to help you make meaningful, sustainable changes.
Stay in the Loop

Yes, I’d like to receive updates, coaching tips, and exclusive offers from KAD Fitness. We’ll only send occasional emails with coaching updates, early offers, and resources.
Should be Empty:

KAD One-Off Nutrition Review: Client Insight Form

Personal & Contact Information

Health History

Nutrition Habits & History