by aimeeleann

New Client Questionnaire

Complete the Questionnaire Below to Help Us Gain Insight Into You and Your Body for Tailoring Your Personalized Plan

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How active are you in the following categories? Ex. (Duration/Times per Week):

Body Measurements (Not Required):

Which of the following best describes you?
Are you a binge eater?
Health and Medical Conditions
Check any health conditions that apply:
Foods you like (Check all that apply):