(1-4 being little intention, 5-7 being ambivalent, 8-10 being very willing)
In the past, what were your most & least successful attempts to lose weight (if applicable)?
(e.g., low calorie, diabetic, low sodium, low fat, low cholesterol, high fiber, vegetarian)
For each of the statements below, choose the answer that most accurately describes your response.
- Please provide your typical day’s schedule for both a weekday and weekend day, be specific with name brands and amounts of food.
- Please provide the time of day you exercise, the type of exercise performed, and how long you exercise. (Please be specific as this will directly affect your meal plan).
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