Do
you wake up feeling tired?
Yes
No
Do
you suffer from an energy loss during the day?
Yes
No
What
is Your Current Weight?
What
is Your Goal Weight?
What
is Your Height?
What
is Your Age?
Gender
Male
What
weight-loss programs have you tried?
How
serious are you about losing weight?
What
is the particular reason you want to lose weight at this time?
How
many times a week do you eat out?
Do you exercise at the moment?
Yes
No
How much water do you drink per day?
Allergies : In the same way as you should not eat certain foods depending on your
Optional
Information - On
an average day, what do you eat for:
