Please supply the following information about your current diet, training, and lifestyle. The more honest and open you are, the better we can help you! 

Name *
List any medical conditions we should be aware of (hypoglycemia, hypothyroid, PCOS, etc).
3 days worth of everything you eat & drink (when, how much, etc.)
• Hours of sleep per night. o What time do you go to bed? o What time do you get up? o How do you feel upon rising? o Do you sleep in a pitch black room? o How is the quality of your sleep?
stress level on a scale of 1-10
Under Stress do you
What is your Goal for fat loss? Health? Overall Goal?