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Diet & Excercise Information Form
Please fill out all fields to receive your comprehensive health plan
Best Edition Client Information Input Form
First Name
Last Name
Email
Age
Gender
Male
Female
Other
Prefer not to say
Height
Weight
Health Conditions
Diabetes Type 1
Diabetes Type 2
Hypertension
Heart Disease
None
Other
Specify condition
Primary Goal
- Select -
Weight Loss
Weight Gain
Weight Maintenance
Muscle Gain
Muscle Maintenance
Specific Goal
Dietary Restrictions
Vegan
Vegetarian
Gluten-Free
Nut-Free
Soy-Free
Lactose Intolerance
Kosher
Halal
Other
Specify restriction
Food Preferences
Activity Level
Sedentary
Lightly Active
Moderately Active
Very Active
Extremely Active
Cooking Experience
Beginner
Intermediate
Advanced
Cooking Time
- Select -
<15 min
15-30 min
30-45 min
>45 min
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