Name *

First Name

Last Name

Phone Number *

used for day-to-day communication

(###)

###

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average activity level *

sedentary (little to no exercise)

light (Light daily activities, like casual walking)

Moderate (regular exercise 30-60 min. most days)

very active (vigorous exercise, like heavy lifting, running, etc. 60+ min. most days)

extremely active (Intense daily activity, typically athletes or demanding jobs)

do you currently track your food? (calories and macros) *

yes, I track my calories and macros and use a food scale

yes, I track my calories and macros but eyeball my foods

no

how accurate would you like to be with tracking your food? (calories and macros) *

most accurate (track food and use a food scale)

pretty accurate (track food and use measuring cups)

mildly accurate (track food and eyeball portions)

I don't want to track my food at all