TinLaneCo Nutrition Questionnaire
This is designed to assist in designing your optimal food plan
Email address *
ABOUT YOURSELF
Add detail, so that I can understand a little bit more about you
Name, Age, Location, Telephone number *
Bit about yourself, please.
Past Medical History *
Medications *
Have you worked with a nutritionist before?
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What is the reasoning for choosing TinLaneCo? What do you want to get out of it?
What areas do you see as ones you can work on?
Any wearable technology and training apps/software you currently use to track, monitor, manage your training & health?
BASELINES
Having some objective measures is KEY to making progress that matters
Have you had a DEXA scan or other body composition assessment?
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Waist Circumference Measurement (the narrowest part of your waist) INCHES *
Your height *
Current Weight and Goal Weight *
EXERCISE & ACTIVITY
Please let me know what you currently do for exercise and training
Describe your activity level and motivation to exercise. *
Are you a member of a gym?
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How many steps do you average per day? If you have a smart phone, it will tell you.
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Hours of exercise per week (take the time to accurately work out what you actually do, not what you think you do, please) *
Currently how many strength sessions are you doing? *
On average how many minutes do you spend on Weights per session?
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How many cardio sessions do you do per week?
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On average how many minutes do you spend on Cardio per session?
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Is there a body part/area that you want an additional focus towards?
Are you currently working with a personal trainer/S&C coach?
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Are the strength and/or cardio sessions:- Class based? - Sessions you or a trainer/coach have constructed?
What type of exercise do you do?
How many years have you been strength training for?
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Are you proficient at the following movements? Barbell squat, barbell front squat, barbell deadlift, chin-up, bench press *
Any exercises you do not do or cannot do? *
Do you have a training partner?
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FOOD & NUTRITION
This lets me understand your habits a little bit better.
My food preference is: *
These are the foods I prefer to eat for breakfast *
Required
These are the foods I prefer to eat for lunch & dinner *
Required
These are the foods I prefer to eat for snacks *
Required
My weakness is......
These are the foods I dislike or refuse to eat *
I have a real food allergy *
Required
I get adverse symptoms (bloating, coughing, reactions etc) from these foods *
Required
I take the following supplements *
Required
I am happy to weigh food (at least initially) to gain an understanding of portion size? *
I prefer simple recipes that are quick and easy? *
I use online grocery shopping weekly *
I often find I run out of food in the house by the end of the week *
LIFESTYLE
Alcohol, sleep and caffeine
Alcohol - what, how often and how much do you drink?
Do you have difficulty sleeping?
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How many hours on average do you get per night?
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How many cups coffee per day do you drink?
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What is the latest time you drink coffee?
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Anything you want to add to assist the process?
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