OptiMeals Questionnaire
Client Intake
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Email *
Name *
Gender *
Required
Age *
Height *
Weight
Your Fitness Goals *
Required
Your Nutrition Goals *
Required
Work/study life (job/school type, hours you work/study each week) *
Social life (how many times they eat out each week etc.) *
Family Life (Married, Children, Parents Home, etc...) *
Drinking Habits *
Recreational Substance Use *
What do you identify as your limiting factors/weak areas when it comes to nutrition? *
What are your favourite foods? *
What Are Your Food Intolerances/Allergies *
Required
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