Reverse Diet Plan
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Age *
Cell Phone Number *
Height (in feet and inches) *
Current Weight *
Current cardio sessions per week? What type of cardio? How long are the sessions? *
Please explain any other workouts done during the week. Length/Type/Intensity *
Do you know how many steps you average per day? If so, how many. *
What does your daily schedule look like? *
What are your current macros that you will be reversing from? *
I understand that Karlie Skinner is not a physician or registered dietician. I will consult with my physician for medical clearance before starting this nutrition program. Information provided by Karlie Skinner is not intended to treat, diagnose, prevent, or cure any health-related problems and it is not intended to take place of the advice of my physician. Information provided by Karlie Skinner will be suggested use only. By submitting this form and participating in this program I am at least 18 years of age and agree to accept full responsibility for my actions. No refunds will be available.  
 *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms