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Products
Vitamins and Essentials
Gut Health & Recovery
Hormones, Stress, and Mood
Pantry Staple
Wellness Plans
Weight Management
Body Transformation
Gut Health & Wellness
Metabolic Care
PCOS & Thyroid Care
Postpartum Health
Exclusive Coaching With Prateek
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Client Health Form
Name
Email
DOB
Gender
What's your Instagram handle?
Fitness Goals :-
What are your main fitness goals?
What are some other health goals you have?
What is your activity level?
Workout preferences
What is your precise current weight? (As of today on an empty stomach) in kgs
What is your ideal long term weight goal? in kgs
How fast do you want to reach your goal? (approx. months)
Waist in cms?
Height in cms?
What is your approx. Body fat %?
Shoulder in cms?
Hips in cms?
Neck in cms?
Dietery Prefernces ?
Do you have any food allergies ?
What are your favourite foods ?
What are your least favourite foods or foods you avoid ?
Do you smoke?
Do you consume alcohol?
Blood tests image if uploaded.
Link
Please upload any current prescriptions you have ?
Link
Do you have Injuries / Surgeries/ Medical conditions?
Front Image
Link
Side Image
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Back Image
Link
Mental & Emotional Health :-
How would you rate your current stress level ?
How offten do you have episodes of emotional eating or binge eating ?
What are your primary sources of stress? (Select all that apply)
What do you do to manage stress? (Select all that apply)
How would you rate your overall mood and mental well-being ?
How do you feel about your current body image ?
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