Wonderfully Fit Nutrition Assessment
This form is intended to help find any areas in your current nutrition habits that need adjustment to help you get better results. Please fill each meal out to the best of your ability, including the time you eat each meal, and what types of proteins, carbohydrates, vegetables, fluids (water, coffee, tea, soda, alcoholic beverages) and other (fats, dressings, seasonings) you eat on a daily basis. If possible, share the quantities you usually consume of each macronutrient at each meal. If you eat fewer than 6 meals, just mark N/A in each section that does not apply to your current daily meal lineup.
Email address *
Name *
Your answer
Age *
Your answer
Height *
Your answer
What is your current weight (in lbs)? *
Your answer
What is your goal or ideal body weight (in lbs)? *
Your answer
What time do you typically wake up each day?
Time
:
What is your typical bed time?
Time
:
Are you currently taking a multivitamin? If yes, what kind? *
Your answer
How many ounces of water are you drinking per day? *
Your answer
How many Calories do you average per day? *
Your answer
Are you currently on a physician or dietician prescribed meal plan? *
Required
Do you have any food allergies or foods that you avoid for other reasons? Please list.
Your answer
Do you ever skip meals during the day? If so, why? *
Your answer
Do you struggle with cravings, even though you may have eaten fairly recently? *
Required
If you exercise regularly, around what time do you get your training session in?
Your answer
What, if anything, do you eat/drink after your workout? (ie. protein shake-if so list type, whole food meal, nothing)
Your answer
What is your profession?
Your answer
What is your current activity level? *
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