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Meal Plan Survey

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

Secured
1

Name

Please provide your full name.
2

Current Body Weight

Please provide your current body weight.
3

Goal: Lose Fat

Select if your goal is to lose fat.
4

Goal: Gain Weight

Select if your goal is to gain weight.
5

Goal: Gain Muscle

Select if your goal is to gain muscle.
6

Current Diet Habits

Briefly describe your current diet habits.
7

Physical Activity Level

How active are you on a daily basis?
8

Food Allergies

Do you have any food allergies or dietary restrictions?
9

Favorite Healthy Foods

List some of your favorite healthy foods.
10

Least Favorite Healthy Foods

List some healthy foods you dislike.