Food interest quiz

Name:

Email:

Do you want to improve your eating habits?

Yes

What foods do you like/dislike?

	Like	Dislike
Avocado
Tomato
Bok choy
Spinach
Cabbage
Lettuce
Sweet potato
Corn
Eggplant
Zucchini
Brussel sprouts
Peas
Carrots
Cucumber
Radish
Salmon
Tuna
Chicken
Lamb
Beef
Pork
Egg
Tofu
Lentils
Chickpeas
Quinoa
Burghal
Freekeh
Brown Rice
White Rice
Goats Cheese

Do you have any dietary requirements?

How many meals do you eat per day?

How often do you exercise per week?

1-2 times

2-4 times

4-6 times

6+ times

What is the purpose of your new meal plan? e.g. To improve eating habits, to lose weight etc.

What is your weight goal?

To lose weight

Maintain weight

Gain weight

Do you have any other notes about your eating habits/ exercise routine?

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