* 1. Name

* 2. Email Address

* 3. Contact Number (Optional)

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

* 5. Do you ever snack in between meals?

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

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

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

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

* 10. What is your favourite food or foods?

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