Metabolic Assessment
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Email *
First and Last Name *
Phone Number *
Gender  *
Age *
Weight *
What are your goals? Fat Loss? Build Muscle? More energy? Please give me as much detail as possible! *
 How much weight are you looking to lose? Or how much weight are you trying to gain?   *
Are there any specific obstacles or challenges you are facing that are preventing you from your goals? *
How many meals do you usually eat a day *
How would you rate your food quality on a scale of 1-10? *
How many calories do you aim for a day? If you aren't sure that's okay! Just give me your best guess below.  *
How would you rate your protein intake on a scale of 1-10? (1 being hardly any 10 being eating 1g/goal weight daily) *
How many and which diets have you tried over the past 3-5 years? *
How much caffeine are you consuming daily? *
How physically active are you? *
Are you following a work out plan? If so what are you doing? *
How many hours of sleep do you get on average each night? *
On average what is the quality of your sleep?
 *
How would you rate your energy level? *
Are there any health related issued I should know about? Allergies, dietary preferences, injuries, hormonal imbalances, etc *
Have you ever considered working 1x1 with a coach?
There is no right or wrong answer :)
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