Name

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* 1. Name

Email Address

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* 2. Email Address

Contact Number (Optional)

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* 3. Contact Number (Optional)

What is your main goal for a nutritional eating plan?

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* 4. What is your main goal for a nutritional eating plan?

Do you ever snack in between meals?

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* 5. Do you ever snack in between meals?

What type of drinks do you have during the day?

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* 6. What type of drinks do you have during the day?

In a typical day, how many of your meals or snacks include carbohydrates?

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* 7. In a typical day, how many of your meals or snacks include carbohydrates?

In a typical day, how many of your meals or snacks include protein?

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* 8. In a typical day, how many of your meals or snacks include protein?

In a typical day, how many of your meals or snacks include vegetables?

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* 9. In a typical day, how many of your meals or snacks include vegetables?

What is your favourite food or foods?

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* 10. What is your favourite food or foods?

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