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1 About You
2 Habits
3 Food
4 Body

Before you begin! This questionnaire is ONLY for clients who have purchased customized meal plans or online coaching. If you have NOT purchased a plan and need help selecting the right plan, please call 1 (888) 304-2843 Mon-Fri 9-5PM EST.

Full Nameyour full name
Instagram Handleyour full name
Cityyour full name
Sex
Age
Height
Current Weight
Goal Weight
Time Frame to reach your goal?
What is your Goal?
Are you pregnant or breastfeeding?
If breastfeeding, approximately how many ounces do you lactate per day?
List 5 meals your typically eat for breakfast:
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List 5 meals your typically eat for lunch:
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List 5 meals your typically eat for dinner:
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Do you use a protein supplement?
If YES, please list (1) the protein supplement that you use (2) calorie, (3) protein, (4) carbohydrate and (5) fat content.
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Do you want a meal plan based on convenience or variety?
How many meals can you reasonably fit into your day?
Comment on the number of meals you can reasonably fit into your day
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What time of day do you workout?
Do you have any experience with weight training?
Do you have a gym membership?
Do you smoke?
What are your weaknesses when it comes to proper diet and nutrition?
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How many days a week can you CONSISTENTLY workout?
What areas would you like to improve on your physique?more details
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Describe your overall goal and typical physique:
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How did you hear about Gauge Girl Training?
Is this your first time working with Gauge Girl Training?
Check any ALLERGIES you have:
Other Allergies:
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Check any PROTEIN sources you WILL NOT eat:Failure to check off an item may result in the inclusion of that food in your program. If you DO NOT explicitly exclude it here, your program cannot be revised.
Check any CARB sources you WILL NOT eat:Failure to check off an item may result in the inclusion of that food in your program. If you DO NOT explicitly exclude it here, your program cannot be revised.
Check any FRUIT and VEGGIE sources you WILL NOT eat:Failure to check off an item may result in the inclusion of that food in your program. If you DO NOT explicitly exclude it here, your program cannot be revised.
Check any FAT sources you WILL NOT eat:Failure to check off an item may result in the inclusion of that food in your program. If you DO NOT explicitly exclude it here, your program cannot be revised.
What best describes your eating style? Check all that apply:

Paleo: A paleo eating style is gluten free, grain free, lactose free, dairy free, soy free, legume free, and artificial sweetener free. There is not added benefit of this style of eating over another unless you have these specific food intolerances or if you are seeking to minimize inflammation from processed foods.

Paleo + Gluten Free Grains: This style is similar to paleo, but includes gluten free grains like rice (white, brown, wild), gluten free oats, quinoa, corn, amaranth, buckwheat, millet, sorgum, and teff. You enjoy real whole foods but do not have any sensitivites to grains and enjoy including them in your meals.

Clean Eating: Clean eating is about eating real whole foods that are minimally processed.This style of eating typically eats 3-6 times a day with a protein and carb with each meal and about 2-3 servings of fat per day.

Diabetic: A diabetic-friendly meal plan is designed to maintain healthy blood sugar levels. This style of eating tends to minimize carbohydrates, saturated fats, and sodium levels.

Pescatarian: A pescatarian style of eating tends to be higher in omega-3 fatty acids from fish for a heart healthy nutrition approach. This excludes chicken, turkey, pork, and red meat. This style of eating includes seafood, eggs, and dairy.

Flexitarian: This emerging style of eating is for those who want to be more plant based overall, but are willing to include things like chicken and fish when needed for the convenience of hitting their protein macros. There is no defined food list, but this is for those to want to be more intentional about eating plant based food choices when they are able to.

Low Carb High Fat: This style of eating is not necessarily defined by macro ratios but tends to be high in fat, moderate in protein, and moderate to moderately low in starchy carbs.

Keto: Keto is a high fat, low carb protocol designed to support improving insulin reistance. This protocol is 70-75% fat, 20-25% protein, and 5% net carbs.

Vegetarian: A vegerarian lifestyle excludes eating meat and  seafoo but allows dairy and eggs.

Vegan: A vegan lifestyle excludes eating meat, seafood, dairy, and eggs and focuses more on using soley plant based ingredients for ones nutritional needs.

Intermittent Fasting: This style of eating has prolonged periods of fasting and concentrated windows of eating. A typical IF protocol is 16:8 where one fasts for 16 hours and eats within an 8 hour period.

No Preference: No eating style is preferred over another. This client will be recommended an approprate eating style.

    Do you have experience calorie counting?
    Do you have experience tracking macros?
    If yes, what are your current macros?
    Do you mind eating the same protein and vegetables at both lunch and dinner?
    What style of macros works best for you?
    Other:

    Menus/Food Style*

    *Please note we may not be able to honor every

    Breakfast:I like these types of breakfasts
    Other things you like for breakfast not listed
    Lunch/Dinner:
    Other things you like for lunch not listed

    What do you want in your meal plan?

    *No means you will not eat this food. 

    **Yes means you can eat this food and this preference is ok to use in your meal plan


    Proteins for my Meal Plan:

    Other things you like for breakfast not listed

    What do you want in your meal plan?

    *No means you will not eat this food. 

    **Yes means you can eat this food and this preference is ok to use in your meal plan


    Protein for my Meal Plan:

    Protein for my meal plan
    Yes**No*
    Ahi Tuna
    Almonds
    Bacon
    Beef Jerky
    Black Bean Spaghetti Pasta
    Cheese
    Chicken
    Chickpea Pasta
    Collagen Peptides
    Cottage Cheese
    Dairy
    Deli Style Meat
    Edamame
    Edamame Pasta
    Egg White Protein Powder
    Egg Whites
    Eggs
    Eggs are part of a recipe (i.e. pancakes)
    Epic Bars
    Greek Yogurt
    Hemp Protein
    Meat Alternatives
    Micellar Casein
    Milk Protein
    Mung Bean Pasta
    Pea Protein
    Peanuts
    Protein Bars
    Protein Shakes
    Pumpkin Seeds
    Quest Bars
    Red Meat (Beef)
    Rice Protein
    Rx Bars
    Salmon
    Seafood
    Seitan
    Shrimp
    Smoked Salmon
    Smoothies
    Soy
    Soy Protein
    Spirulina Powder
    Sunflower Seeds
    Tilapia
    Tuna
    Turkey
    Turkey Bacon
    Turkey Jerky
    Whey Protein

    What do you want in your meal plan?

    *No means you will not eat this food. 

    **Yes means you can eat this food and this preference is ok to use in your meal plan


    Fats for my Meal Plan:

    Fats for my meal plan
    Yes**No*
    Almond Butter
    Almonds
    Almond Milk
    Avocado
    Butter
    Cashew Butter
    Cashew Milk
    Cheddar Cheese
    Chia Seeds
    Coconut Manna (Butter)
    Coconut Milk
    Coconut Oil
    Feta Cheese
    Flax Seeds
    Ghee
    Goat Cheese
    Hummus
    Macadamia Nuts
    Mozzarella Cheese
    Olive Oil
    Olives
    Parmesan
    Peanuts
    Pistachios
    Sesame Oil
    Shredded Coconut
    Soy Milk
    String Cheese
    Sunflower Seeds
    Tallow
    Walnuts
    Whole Milk

    What do you want in your meal plan?

    *No means you will not eat this food. 

    **Yes means you can eat this food and this preference is ok to use in your meal plan


    (Carbs) Starches for my Meal Plan:

    Carbs/Starches for my Meal Plan:
    Yes**No*
    Acorn Squash
    Almond Flour
    Almond Flour Tortillas
    Apple Sauce (Unsweetened)
    Beets
    Brown Rice
    Butternut Squash
    Cocoa Powder
    Coconut Flour
    Corn
    Corn Tortillas
    Couscous
    Eggplant
    English Muffins
    Ezekiel Bread
    Gluten Free Bread
    Gluten Free Oatmeal
    Gluten Free Pasta
    Granola
    Honey
    Instant Oatmeal
    Legumes
    Lentils
    Marinara Sauce
    Matcha Powder
    Oatmeal Flour
    Oats
    Pesto Sauce
    Pitas
    Polenta
    Protein Pancake Mix (Kodiak Cakes)
    Pumpkin Puree
    Quinoa
    Quinoa Bread
    Red Potatoes
    Rice Cakes
    Rx Bars
    Siete Tortillas
    Spaghetti Squash
    Steel Cut Oats
    Sweet Potato Chips
    Sweet Potato Fries
    Sweet Potatoes
    Wheat Flour Tortillas
    White Rice
    Whole Wheat Bread
    Whole Wheat Pasta
    Wild Rice
    Zucchini

    What do you want in your meal plan?

    *No means you will not eat this food. 

    **Yes means you can eat this food and this preference is ok to use in your meal plan


    (Carbs) Veggies + Fruits for my Meal Plan:

    Carbs/Veggies and Fruits for my Meal Plan:
    Yes**No*
    Apples
    Arugula
    Asparagus
    Banana
    Banana Chips
    Basil
    Bell Peppers
    Blackberries
    Blueberries
    Bok Choy
    Broccoli
    Brussels Sprouts
    Canteloupe
    Carrots
    Cauliflower
    Celery
    Cilantro
    Collard Green Leaves
    Craisins
    Cucumber
    Grapefruit
    Grapes
    Honeydew
    Iceberg Lettuce
    Kale
    Mango
    Mixed Berries
    Onions
    Oranges
    Peaches
    Pears
    Peas
    Pineapple
    Plantains
    Raisins
    Raspberries
    Romaine Lettuce
    Snow Peas
    Spinach
    Strawberries
    String Beans
    Tomatoes
    Watermelon
    Zucchini
    What exercises can you NOT perform?
    Have you ever experienced an eating disorder?IF YES, THIS PROGRAM IS NOT FOR YOU and we recommend seeking guided medical support from a qualified medical specialist. Please contact the national eating disorder association at nationaleatingdisorders.org.

    Picture Submission Requirements: ONLY SUBMIT 3 PICTURES. (Preferably in a bathing suit, but If you are not comfortable being photographed in a bathing suit, a sports bra and shorts is acceptable). 

    • In a full length mirror (if taking pictures yourself) or have someone take them for you 
    • Good Lighting 
    • Minimal clutter in the background
    • Use same outfit every week during our check-ins.

    Please take the images from the following angles: FRONT, SIDE and BACK:

    Fileupload
    cloud_uploadUpload
    Commentsmore details
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    Please review your answers for accuracy. Any dietary or training needs NOT mentioned will NOT be accounted for in your program UNLESS THEY ARE EXPRESSLY WRITTEN.

    Yes I have reviewed my answers and understand that the program CANNOT be re-adjusted to accommodate for changes after hitting "SUBMIT."
    Do you want to review your questionnaire answers over the phone?
    What is your preferred method of contact?

    Please note: Programs are sent out within 10-12 business days after your phone call.

    What is the best phone number to reach you at?
    If you chose "other," please provide that method of contact here
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