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Nutrition Consultation Form
Please provide a 3 day food journal/log (does not need to be perfect/exact amounts but just a general representation of a typical day consumption)
Do you have any existing medical conditions?
How many calories a day do you consume?
How much water a day do you consume?
How many meals a day do you consume?
Please list some of your favorite foods:
Please list some of your least favorite foods?
Do you have any allergies or aversions?
Do you take any supplements or vitamins
What have you previously tried in the past? What did you like/what did you like? What worked/didn't work for you?
What has hindered you from achieving your goals previously?
What are some of your nutrition goals you are willing to commit to?
Thanks for submitting!