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Cooking Intake
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Name:
*
Your answer
Email address:
*
Your answer
Mailing Address
Your answer
List any food sensitivities or dietary restrictions
*
Your answer
The thing(s) I need most help with in the next 90 days is:
*
Learning what items to have at home
Learning how to cook a balanced meal (i.e. portions sizes, needed nutrients, etc.)
How to use food for proper hormone health (i.e. fertility, perimenopause, menopause, etc.)
How to use food to increase my energy levels
How to use food to balance my blood sugar
Required
On a regular basis, how much time are you willing to spend cooking
*
less than 30 minutes
30 minutes to an hour
an hour to two hours
As long as it takes
Which of the following do you
not
own in your personal kitchen?
*
Microwave
Oven
Blender
Food proccessor
Mixer
measuring cups or spoons (dry or liquid)
Oven-safe equipment (baking sheets, baking pan, etc.)
Pots and pans
Are you interested in meal prepping recipes (i.e. cooking large batches of food in one day to eat over several days)
Yes
No
From time to time
Clear selection
Additional Comments or Concerns
Your answer
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