| New
OA and OA questionaire
This helps
me tailor your plan to you
The following are the things I need to know. You can elaborate
on anything you want. Believe me, I’ve seen and heard everything
and done a lot myself. : )
Face to face is best but this has worked so far with my people
You can fax it to me too 734-284-8590
Fees for nutrition plan
and aftercare $85
Add the exercise plan + $15
You don’t pay me til after my work is done…you have your plan
emailed and my pack of info snail mailed.
ABOUT YOU
· Any "story" or history that you think is
important that I know and help me get to know and understand
you better. You can include weigh history, life altering events,
any gastric bypass surgery etc
· Age
· Height
· Weight
· Where you want to be, if you're not there yet. And
if you don't know we can always come up with something and re-negotiate
it later
MEAL PLAN
· Is it "safe" for you to know your calorie
level or do you want me to keep it to myself?
· Do you want 3 meals and 3 snacks
· Or just 3 meals
· Or any combination
· What time do you
normally eat your meals
· What is your current
plan if you have one
· What do you like
about it, or want to change
· What foods do you
currently plug in to this plan?
· Any food allergies
· What are your trigger
foods
· What is safe, what
is not
· What are your favorite
(non trigger foods) and what do you hate
· Is it
"safe" for you to know your calorie level or do you
want me to keep this to myself. You won't be counting cals,
that's my job.
MEDICAL HISTORY
· Anything medically I should know that wasn't mentioned
initially
· Medications?
EXERCISE (let me know what you do even if you're not having
me do the exercise assessment, I need to know so I make sure
your calories are appropriate based on your activity). If I
am doing the assessment please be detailed.
· Any orthopedic
limitations to exercise or medical issues
· What do you like to do
· Hate
· Have access to at a gym or home
· Wish to learn
· Anything else you have an opinion on
HOME ADDRESS or wherever you want me to send my pack of info.
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