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Dietary Intake

Client Information

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Last Name *

Email *

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Age *

Gender *

Height *

Weight *

Body Fat % (BFP) *

Method to Estimate BFP *

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Exercise & Diet Information

Steps per Week

Current Workout *
(Duration & Sessions/Week)

Current Cardio *
(Duration & Sessions/Week)

Dietary Considerations
(i.e., vegan, paleo, vegetarian, etc.)

Other Information
(i.e., health conditions or considerations, heart issues, diabetic, other relevant information, etc.)

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