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Nutrition consultation form

The Nutrition Consultation Form is a document that is analyzed by a nutritionist or dietitian in order to assess a client’s nutritional needs. It usually includes information like the general food habits, dietary restrictions, any medicines that are taken during the period of consulation.

2 minutes to complete

Eligibility

The form needs to be filled out by any patient who is willing to get a nutrition consultation.

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Questions for Nutrition consultation form

Questions

1.

What is your current weight?

The answer should be a text input.
2.

What is your height?

The answer should be a text input.
3.

What are your eating habits like? (Do you eat breakfast? How many times a day do you eat?)

The answer should be a text input.
4.

What foods do you typically eat in a day?

The answer should be a text input.
5.

What are your thoughts on healthy eating?

The answer should be a text input.
6.

Do you have any medical conditions?

The answer should be a single choice:
  1. Yes
  2. No
7.

Are you trying to lose weight?

The answer should be a single choice:
  1. Yes
  2. No
8.

Are you trying to gain weight?

The answer should be a single choice:
  1. Yes
  2. No
9.

What are your fitness goals?

The answer should be a text input.
10.

What is your current activity level?

The answer should be a text input.

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Here are some FAQs and additional information
on
Nutrition consultation form

How much does a nutrition consultation cost?

A nutrition consultation typically costs between $50 and $200. However, the cost will vary depending on the nutritionist's experience, qualifications, and the type of consultation you require.

What happens during a nutrition consultation?

During a nutrition consultation, the nutritionist will assess your current diet and health status. They will then provide you with tailored dietary advice and recommendations.

What types of nutrition consultations are available?

There are many different types of nutrition consultations available, depending on your needs. Some common types of consultations include: -Initial consultation: During an initial consultation, the nutritionist will assess your current diet and health status. They will then provide you with tailored dietary advice and recommendations. - Follow-up consultation: Follow-up consultations are typically shorter than initial consultations. They are usually conducted to check your progress and make any necessary adjustments to your diet plan. - Group consultation: Group consultations are conducted with a group of people, rather than individually. They can be useful for people who want to learn about nutrition together, such as families or employees.

What are some tips to fill nutrition consultation form?

Be prepared about your food practices, Note down any foods that you are allergic to, Consult your general physician before taking any different foods that are suggested. Specify your medications with proper dosage levels.

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