1. What is your age? years
2. What is your weight? lbs.
3. What is your height? feet inches
4. What is your target weight? lbs
5. Are you male or female? Male Female
6. What are your personal goals in terms of weight and fitness? Weight loss and Toning Maintain weight and Toning Gain Weight and Toning
7. How many meals do you eat per day including snacks? 1 to 3 3 to 6 6+
8. How would you describe your weekly exercise? little or no exercise moderate -exercise 1 to 3 days per week very active -exercise 3 to 5 days per week
9. Are you lactose intolerant or sensitive to dairy products? Yes No
10. Do you feel bloated or fatigued after eating? Yes No Never really noticed
11. Do you often crave foods that you know to be unhealthy? Yes No Never really noticed
12. Do you have trouble finding the time to cook healthy? Yes No
13. Do you find eating healthy to be too expensive? Yes No
