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1 About You
*First Nameyour first name
*Last Nameyour last name
Instagram Handleyour full name

Before you begin, please note that you must be 18 years old or older. 

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.

Cityyour full name
State
Country
*Sex
*Age
*Birthdate
*Height
*Current Weight
*Goal Weight
Rate of Weight Loss*
Comment on rate of weight loss.
*Have your ever been diagnosed with any hormonal issues?
*Are you pregnant or breastfeeding?
If breastfeeding, approximately how many ounces do you lactate per day?
*List 4 meals your typically eat for breakfast:
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*List 4 meals your typically eat for lunch:
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*List 4 meals your typically eat for dinner:
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*Would you like your menus to be similar to what you typically eat?
*Do you use a protein supplement?

If YES, please take a picture of the nutrition label of your protein supplement. This should include: (1) the name of the protein supplement (2) calorie, (3) protein, (4) carbohydrate, (5) fiber, and (6) fat content.

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*Do you use any other supplements (i.e. BCAAs, pre-workout, protein bars, fish oil, benefiber, etc)?

If YES, please take a picture of the nutrition label of any supplement you use. If applicable, this should include: (1) the name of the supplement (2) calorie, (3) protein, (4) carbohydrate, (5) fiber, and (6) 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?
*How many minutes can you commit to each workout session?
Describe your typical daily activity (outside of working out). Are you seated and sedentary? Are you on your feet?more details
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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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*Choose your program:
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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*What best describes your eating style? Check all that apply:
*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?
*Would you like to have any of your menus to contain the same meal for both lunch and dinner?
*What style of macros works best for you?
Other:

List 5 or more of your favorite protein sources below (e.g. fish, chicken breast, tofu, beans).

List 5 or more of your favorite protein sources here.
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List 5 or more of your favorite fat sources below (e.g. olive oil, cheese, nuts, seeds, avocado).

List 5 or more of your favorite fat sources here.
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List 5 or more of your favorite fruits below.

List 5 or more of your favorite fruits here.
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List 5 or more of your favorite vegetables below.

List 5 or more of your favorite vegetables here.
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Menus/Food Style*

*Please note we may not be able to honor every request.

*Breakfast:I like these types of breakfasts.
*Lunch:I like these types of lunches.
*Dinner:I like these types of dinners.

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:

Protein for my meal plan
Yes**No*
Ahi Tuna
Almonds
Bacon
Beef Jerky
Bison
Black Bean Spaghetti Pasta
Built Bars
Cod
Chicken
Chickpea Pasta
Chicken Sausage
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
Mahi Mahi
Meat Alternatives
Micellar Casein
Milk Protein
Mung Bean Pasta
Mung Bean Sprouts
Pea Protein
Pepperoni
Pork Sausage
Protein Bars
Protein Pancakes (homemade)
Protein Shakes
Prosciutto
Quest Bars
Red Meat (Beef)
Rice Protein
Rx Bars
Salami
Salmon
Scallops
Seitan
Sea Bass
Shrimp
Smoked Salmon
Smoothies
Soy
Soy Protein
Spirulina Powder
Tofu
Tempeh
Tilapia
Tuna
Turkey
Turkey Bacon
Turkey Jerky
Turkey Sausage
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
Avocado Oil
Butter
Blue Cheese
Cacao Nibs
Cashews
Cashew Butter
Cashew Milk
Cheddar Cheese
Chia Seeds
Coconut Manna (Butter)
Coconut Milk
Coconut Oil
Feta Cheese
Flax Seeds
Ghee
Goat Cheese
Gorgonzola Cheese
Half and Half
Heavy Cream
Hemp Seeds
Hummus
Macadamia Nuts
Mayonnaise
MCT Oil
Milk, 1%
Milk, 2%
Milk, Skim
Milk, Whole
Mozzarella Cheese
Oat Milk
Olive Oil
Olives
Parmesan
Peanut Butter
Peanuts
Pecans
Pesto Sauce
Pine Nuts
Pistachios
Pumpkin Seeds
Provolone Cheese
Sesame Oil
Sesame Seeds
Shredded Coconut
Soy Milk
String Cheese
Sunflower Seeds
Sunflower Oil
Tallow
Vegetable Oil
Walnuts

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
Black Beans
Brown Rice
Butternut Squash
Chickpeas (Garbanzo Beans)
Cinnamon
Cocoa Powder
Coconut Aminos
Coconut Flour
Corn
Corn Tortillas
Couscous
English Muffins
Ezekiel Bread
Garlic
Gluten Free Bread
Gluten Free Oatmeal
Gluten Free Pasta
Granola
Honey
Hot Sauce
Instant Oatmeal
Kidney Beans
Lentils
Marinara Sauce
Matcha Powder
Oatmeal Flour
Oats
Pinto Beans
Pitas
Polenta
Protein Pancake Mix (Kodiak Cakes)
Pumpkin Puree
Quinoa
Quinoa Bread
Red Lentil Pasta
Red Potatoes
Rice Cakes
Rx Bars
Siete Tortillas (Almond Flour Tortillas)
Soy Sauce
Spaghetti Squash
Sriracha
Steel Cut Oats
Sweet Potato Chips
Sweet Potato Fries
Sweet Potatoes
Wheat Flour Tortillas
White Bread
White Rice
Whole Wheat Bread
Whole Wheat Pasta
Wild Rice

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
Artichokes
Arugula
Asparagus
Banana
Banana Chips
Basil
Bell Peppers
Blackberries
Blueberries
Bok Choy
Broccoli
Brussels Sprouts
Cabbage
Cantaloupe
Capers
Carrots
Cauliflower
Celery
Cilantro
Collard Green Leaves
Craisins
Cucumber
Dates
Eggplant
Grapefruit
Grapes
Honeydew
Iceberg Lettuce
Jalapeno Peppers
Kale
Mango
Mixed Berries
Mushrooms
Onions
Oranges
Peaches
Pears
Peas
Pineapple
Plantains
Pomegranate Seeds
Radishes
Raisins
Raspberries
Romaine Lettuce
Salsa
Snow Peas
Spinach
Strawberries
String Beans
Tomatoes
Turnips
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). 



NOTE: MUST BE IN JPG or PNG FORMAT (with a max file size of 8000kb each image)

  • 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:

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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."
*What is your preferred method of contact?

Please note: Programs are sent out within 5-7 business days after your phone call.

*What is the best phone number to reach you at?
What time do you prefer to be contacted?
If you chose "other," please provide that method of contact here
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