Personal Training Nutrition Questionnaire Name Today's Date Age Gender Email Do you have any known allergies or food intolerances? Are you currently taking any medications or supplements? How would you describe your current level of physical activity? Sedentary Light Moderate Active Very Active Do you follow a specific diet? Are there any foods you dislike or will not eat? Do you consume alcohol? How many meals and snacks do you typically eat in a day? How comfortable are you with cooking? Very Comfortable Somewhat Comfortable Not Comfortable How many times a week do you prefer to cook? Do you have a preference for meals that take a certain amount of time to prepare? Are there specific cooking techniques or equipment you prefer to use or avoid? Would you be interested in simple recipes and meal prep suggestions tailored to your goals? Yes No What are your primary nutrition and fitness goals? Do you have any specific macro or calorie targets you aim for daily? Have you worked with a nutritionist or dietitian before? Where do you usually eat your meals? How many times do you eat out in a week? Do you skip meals? On a scale of 1-10, how would you rate your current nutrition knowledge? Do you feel you have the support you need from family or friends when it comes to making healthy food choices? Yes No What challenges do you face when trying to eat healthily? Have you ever used a phone app for food logging or calorie counting? Did you find success or any particular benefits from using this/these app(s)? Very Successful Somewhat Successful Not Successful Never Consistently Used It If you haven't used an app for food logging or weren't successful with it, would you be open to using an app to log your food in the future? Yes, I would be open to it. Maybe, I'd need some guidance. No, I prefer not to use an app for food logging. Do you have any religious or cultural food practices or restrictions that I should be aware of? Have you ever experienced any eating disorders or disordered eating behaviors? Is there anything else you would like me to know about your nutrition or dietary needs? Send
