Customized Diet Plan
Pls. share information below to enable our experts to create a plan for you basis your goals & preferences
Weight (in Kgs)
Height (in centimetres) (1 feet = 30 cms)
Meals you generally have
Mid Day Snack
How often do you eat out?
Once a week or less
Twice a week
Thrice or more in a week
Highly Active (More than an hour of rigorous activity 5-7 days weekly)
Active (30-60mts of exercise 5-7 days weekly)
Medium (15-30mts of exercise 5-7 days weekly)
Low (Less than 15mts of exercise 5-7 days weekly)
What form of exercise do you do/like to do?
Rate your self motivation on scale of 1-5. 5 being Very High
What type of job do you have?
How many hours of sleep do you get daily?
Less than 6hrs
8 or more hours
How many glasses of water do you drink daily?
6 or less
8 or more
Tell us your typical routine (Will help us serve you better)
e.g. Mon-Fri: Up at 6:30AM. Regular Tea at 7AM. Run from 7:30-8AM, Breakfast (egg & toast) at 9AM. Coffee at 11AM, Lunch (1 bowl veg, dal, 1 bowl rice) at 1PM, Regular Tea & Namkeen/Biscuit at 4PM, Dinner (Veg/Chicken/Fish & 2Roti) at 9PM, Sleep by 11PM). Weekends 2 meals out (Heavy Indian food).
Any medical conditions?
Heart Related Issues
Any food allergies?
Any injuries/surgeries/illness past 2 years. Pls. specify
Do you smoke/drink? If yes, pls. specify frequency.
Are you taking any medication currently? Pls. specify
Any other information you'd like to share?
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service