Tough Love Meal Prep Questionnaire

What is your name?

What is your age?

If you are under 18, what grade are you currently in?
If over 18, please respond N/A.

What is your occupation? If under 18, please respond N/A.

What is your height and weight?

What is your goal? Are you trying to lose weight, gain weight, or maintain a healthy diet?

Do you have any dietary restrictions?

Do you have any allergies that we need to be aware of?

How many meals per week do you need?

List some foods you strongly dislike.
(This can include protein, vegetables, or carbohydrates)

List some foods you especially enjoy or would like to include more in your diet.
(This can include protein, vegetables, or carbohydrates)

How often do you work out?

How long are your workouts?

How intense are your workouts?

Is there any other information you would like to include?

Please provide contact information below:

Parent’s Name (If under 18) Please respond N/A if over 18:

Phone Number (Parent’s Number if under 18)
Please respond N/A if you would not like to provide your number:

Email Address (Parent’s Email if under 18):

If you are human, leave this field blank.

324-C Orange Rd. Montclair, NJ 07042

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