1 Did you grow up drinking well water, faucet water, bottled water, or filtered water?
Bottled Water |
2 Did you have home cooked meals as a child, or did you eat fast food and at restaurants growing up?
Both |
3 How many meals a day did you eat as a child?
2x |
4 Did you pack a lunch to school, or did you eat the school’s breakfast and lunch?
Ate school’s breakfast and lunch |
5 Did you drink a lot of sodas, juices, or kool-aid growing up?
No |
6 Did you eat junk food and candy as a child?
Yes |
If so, how many times a day?
1x |
7 Do you currently drink alcohol?
Yes |
If so, how many times in a week?
4x |
What types of alcoholic drinks do you consume?
Vodka |
Are you an alcoholic?
|
Do you use drinking alcohol to numb yourself from your traumas, pains, and problems?
|
If Yes, Please Explain
|
Why do you drink alcohol?
|
How old were you when you had your first alcoholic beverage?
Teenager |
8 Do you currently eat fast food and at restaurants?
Yes |
If so, how many times in a week?
1x |
Where do you normally eat at?
Sushi. |
9 Do you cook your meals at home?
Yes |
If so, how many times in a week?
More |
10 Do you currently consume sugary foods or desserts?
Yes |
If so, how many times in a week?
4x |
What do you eat?
Candy, chocolate. Every day I have something sweet. |
11 Do you incorporate whole foods in your nutrition?
Yes |
12 Do you eat fruits and vegetables?
Yes |
What are your favorite fruits?
Frozen grapes, peeled apple slices with lime, kiwi with honey. |
What are your favorite vegetables?
I don't have a favorite vegetable but I will eat them. |
13 Do you purchase organic produce?
Yes |
If so, what produce do you buy organic?
All of them are always organic at the market. |
14 Do you purchase organic groceries?
Yes |
If so, what groceries in particular do you buy organic?
Fruits, vegetables, ground beef. |
15 Do you follow any particular diet or nutritional lifestyle?
No |
Which nutritional lifestyle do you currently follow
|
Please type the nutritional lifestyle that you follow
|
16 Do you eat to live or live to eat?
Eat to Live |
17 What is your relationship with food?
It's complicated, I forget to eat! |
18 Are you an emotional eater?
Yes |
19 Do you struggle with cravings?
Yes |
If so, what foods do you crave?
Chocolate |
20 Do you have any food allergies or intolerances?
Yes |
If so, please list all food allergies and intolerances in detail
Allergic to walnuts, pecans, watermelon and dairy tends to flare my acne. |
21 How many ounces, cups or gallons of water do you drink a day?
Maybe 30 ounces a day. |
22 What type/brand of water do you mostly drink?
Essentia Water Bottles |
23 Are you a coffee drinker?
Yes |
How many cups of coffee per day do you drink?
1 |
24 Do you consume energy drinks, soda/pop, or other caffeinated beverages?
No |
If so, please list them in detail.
|
25 Please list in detail what a typical day of eating looks like.
Morning: 3-4 boiled eggs, FAGE 0% yogurt with honey and AG1 with 8oz of water.
Lunch: chopped up chicken with a whole avocado and a banana
Cravings: any kind of chocolate, skittles or grapes
Dinner: Protein Shake some nights or I repeat my lunch |
26 Is there anything else you would like to share in this section that wasn’t mentioned? Remember all information is confidential.
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consultation_post_id
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order
5010 |
