ReNew Nutrition Client Quiz Name * First Name Last Name Email * Phone (###) ### #### Age * Height & Current Weight What are your top 3 nutrition/health goals? * Weight loss Muscle gain Improve energy Better digestion/gut health Balance hormones Lower inflammation Improve relationship with food Other (please explain) Why do you feel NOW is the right time to focus on your nutrition? On a scale of 1–10, how committed are you to making nutrition changes right now? Current Nutrition Habits How many meals do you usually eat per day? Do you snack often? If yes, what are your go-to snacks? Do you currently track calories or macros? Do you drink alcohol? If yes, how often? How much water do you drink daily? Dietary Preferences & Restrictions Do you follow any specific diet? None Vegetarian Vegan Pescatarian Gluten-free Dairy-free Other (please list) Any food allergies or intolerances? Are there foods you absolutely love and want included? Are there foods you dislike or want excluded? Lifestyle & Health Focus How active are you on a weekly basis? Sedentary (little to no activity) Lightly active (1–2 workouts/week) Moderately active (3–4 workouts/week) Very active (5+ workouts/week) What type of exercise do you do most? (Cardio, strength training, yoga, sports, etc.) Do you currently deal with any health conditions (thyroid, diabetes, PCOS, gut issues, etc.)? Mindset & Support What has held you back from reaching your nutrition goals in the past? Do you prefer a strict plan to follow or flexible guidelines with options? What kind of accountability works best for you? Daily check-ins Weekly reviews Flexibility & independence Final Check If you could fast-forward 3 months, what would success look like for you? Is there anything else I should know to help me support you on your journey? Thank you for taking the time to complete this questionnaire. We look forward to helping you achieve your goals and create a healthier, more fulfilling life.
