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Initial Assessment Questionnaire

Please fill out the following form to submit your initial assessment. 

How did you hear about E3 Nutrition?
How excited are you to learn how to make better nutritional decisions that improve your total Health and Wellness?
Is there a specific E3 Nutrition Coach you want to work with?
What's currently preventing you from hitting your nutritional goals? (Select all that apply) Required
How often do you exercise? (Be conservative with this question)
How often do you eat out? (Over-exaggerate this question)
How would you describe your current diet?
How familiar are you with weighing and/or measuring your food/drinks?
How familiar are you with identifying food(s) as a carbohydrate, fat, or protein?
Describe your experience with using macronutrients as allowances for food intake. (Commonly called "Counting Macros")
Are you also interested in 1:1 Personal Training from E3?
What type of training/exercise are you currently doing? (Select all that apply) Required
How many days/week can you consistently commit to training?
What are your end goals with this program? (Select all that apply) Required
Are there any very specific goals you'd like to reach within the answer(s) given above?
What type(s) of gym equipment do you have full access to?
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