Let's Get to Know Each Other

I live to guide individuals on how to live healthy lives. Before I give you the lowdown on my services and the details of my program, I want to learn a bit more about YOU!

I deeply value each and every client I take on, so it’s important to figure out if we are a great fit to reach your goals.

Name

Mobile Phone

Facebook Link

Marital Status

Age

Weight

Height

Do you have any medical conditions? If yes, please list.

Are you on any medications? If yes, please list.

Do you have allergies? If yes, please list.

How many times per week do you exercise?

What is your blood type?

What is your daily routine. Please be as detailed as possible.

Do you currently work? If yes, what type of work do you do?

What are your work hours? How many days per week do you work?

How many hours (on average) of good sleep do you get at night?

What time do you usually wake up? How often do you wake up late?

How many times per week do you go out for dinner?

How would you describe your eating habits? Please be as detailed as possible.

How much water do you drink daily?

Do you like to snack?

What type of fruit do you eat daily?

What type of vegetables do you eat daily?

How many meals do you have daily?

How many snacks do you have daily?

Do you eat after 7 pm?

What time do you start eating in the morning?

Name one food that you can't live without

How do you feel about fasting?

How do you feel about intermittent fasting?

What type of diets have you tried in the past? Have they worked? Please be detailed.

FINALLY, please tell me your weight and health goals:

Let's Get to Know Each Other

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