Nutrition Client Questionnaire
Please complete the following questionnaire to apply for nutritional coaching.  Whether you are looking for a one time nutritional assessment or are wanting monthly coaching.

Monthly Nutritional Coaching:  I practice flexible dieting through macro counting.  There are no meal plans and no foods off limits.  Nutritional coaching includes weekly check ins, macros adjustments and cardio recommendations.  Client must track macros through MyFitnessPal Pro addition, invest in a food scale and have a body weight scale for weekly weigh ins.  All client check ins are Friday morning before noon via email. These are not in person check ins.

Keep in mind weight-loss, muscle gain and body recomp takes TIME. I require a minimum of 3 months of nutrition coaching as it does take time to see results
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Email *
Name *
Are you currently following a nutrition program? *
Required
If you answered yes to above, please tell me what type of program you are following and your current macro set.
Do you have a current or past eating disorder? *
Required
If you answered yes to an eating disorder, please give me more information below.
I only accept clients who are willing to make lifestyle changes. Are you willing to put in the work? *
Required
What type of diet do you follow? *
Required
Tell me more about yourself: (job, kids, hobbies, etc) *
Tell me about your current exercise habits *
Age *
Height *
Current Weight *
Goal weight
What is your current goal? *
Required
How many meals do you normally eat in a day? *
Tell me about your current nutrition habits *
Where do you feel like you are falling short? *
I require a 3 month commitment with custom nutrition coaching. Are you will to make that commitment? *
How did you hear about me? *
Any other additional information you think I should know?
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