The form needs to be filled out by any patient who is willing to get a nutrition consultation.
What is your current weight?
What is your height?
What are your eating habits like? (Do you eat breakfast? How many times a day do you eat?)
What foods do you typically eat in a day?
What are your thoughts on healthy eating?
Do you have any medical conditions?
Are you trying to lose weight?
Are you trying to gain weight?
What are your fitness goals?
What is your current activity level?