PRE-ASSESSMENT QUESTIONNAIRE

Please fill out the questionnaire as best you can to get started. In order for our team to create a plan best suited towards you, we ask that you are 100% honest with your answers.

Name *

Gender *

Weight (KG) *

Dietary Requirements

Activity Level *

Current Goal *

Do you add sugar to food or drink almost every day? *

Do you eat food with added sugars almost every day? *

Do you use large amounts of salt in your food? *

Do you drink more than one cup of coffee most days? *

Do you have caffeinated drinks after 4pm? *

Do you smoke on a daily basis? *

Do you take recreational drugs? *

Do you drink more than one regular sized alcoholic drink every day? *

Do you eat fried food more than twice a week? *

Do you eat processed ‘fast food’ more than twice per week? *

Do you eat processed meats more than twice per week? *

Do you often eat foods containing additives and preservatives? *

Do you eat chocolates, pastries, or sweets more than twice per week? *

Do you drink less than 500ml of plain water per day? *

Does less than a third of your diet consist of fruit and vegetables? *

Do you normally eat white rice, flour or bread rather than wholegrain? *

Do you have less than 500ml of milk or yoghurt per week? *

Do you eat more than four slices of bread per day, on average? *

Are there some foods you feel ‘addicted’ to?

Do you eat oily fish less than twice per week and/or seeds less than daily? *

PRE-ASSESSMENT QUESTIONNAIRE

Please fill out the questionnaire as best you can to get started. In order for our team to create a plan best suited towards you, we ask that you are 100% honest with your answers.

Name *

Gender *

Weight (KG) *

Dietary Requirements

Activity Level *

Current Goal *

Do you add sugar to food or drink almost every day? *

Do you eat food with added sugars almost every day? *

Do you use large amounts of salt in your food? *

Do you drink more than one cup of coffee most days? *

Do you have caffeinated drinks after 4pm? *

Do you smoke on a daily basis? *

Do you take recreational drugs? *

Do you drink more than one regular sized alcoholic drink every day? *

Do you eat fried food more than twice a week? *

Do you eat processed ‘fast food’ more than twice per week? *

Do you eat processed meats more than twice per week? *

Do you often eat foods containing additives and preservatives? *

Do you eat chocolates, pastries, or sweets more than twice per week? *

Do you drink less than 500ml of plain water per day? *

Does less than a third of your diet consist of fruit and vegetables? *

Do you normally eat white rice, flour or bread rather than wholegrain? *

Do you have less than 500ml of milk or yoghurt per week? *

Do you eat more than four slices of bread per day, on average? *

Are there some foods you feel ‘addicted’ to?

Do you eat oily fish less than twice per week and/or seeds less than daily? *

WHAT’S INCLUDED?

DAILY MACRONUTRIENT
CALCULATIONS

DAILY CALORIE
INTAKE

FUNDAMENTAL
NUTRITION TIPS

NUTRITIOUS RECIPES
TO FOLLOW

FREQUENTLY ASKED QUESTIONS

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Is the plan personalised to me?

Yes - Your macronutrient and calorie intake is calculated based on a number of individual factors and are specific only to you. Also, key information in the plan is derived from the analysis of your personal assessment.

Does the plan cater for my dietary requirements?

Yes - Whist the plan does encourage a broad, balanced diet, it caters for all major dietary requirements, allergies and intolerances

Would I need to receive an updated plan after a certain amount of time?

No - The plan educates you how to make the right choices for the long term and more importantly, how to sustain them. Your macro and calorie calculations may need adjusting when personal factors change but we teach you how to do this. If you prefer, we’ll do it for you!

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