Custom Meal Plan Questionnaire

Please answer the following questions to help us create a custom meal plan specific to you and your goals:

1/7: Which option best describes your daily activity level? *

Sedentary - Little to no exercise

Normal: Light exercise or sports 1-4 days a week

Moderate: Exercises 2-3 days per week

High: Full time workout schedule or hard manual labor

2/7: On average, how many days do you workout per week? *

0-1 days

2-4 days

5-7 days

3/7: Which option best describes your typical workout? *

3. Which best describes your typical workout?

Don't exercise, walking, steady-state cardio, yoga or pilates
Traditional weight lifting, jogging, bootcamps
CrossFit, HIIT workouts, competitive sports
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4/7: How many times per day, including snacks, do you eat? *

1-2

3-4

5-6

5/7: On average, how often do you eat breakfast? *

1. Never (or just coffee/energy drinks)

2. I eat breakfast 1-3 days per week

3. I eat breakfast 4-6 days per week

4. I eat breakfast every day

6/7: Which of these best describes your goal? *

1. Lose body fat AND gain or maintain muscle

2. Lose body fat BUT I'm okay with losing some muscle

3. Gain weight 1:1 muscle to fat (Heavy bulk)

4. Gain weight 2:1 muscle to fat (Lean bulk)

7/7: Is there anything else you'd like your nutrition coach to know?

Full Name *

Phone *

Email *

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