Client Intake Form Macro Missionary Fill this our completely and honestly so we can formulate your planName*Enter your first and last nameEmail* Please, enter your emailPhone Number*How did you hear about Macro Missionary?*Age*Weight (in lbs)*Enter Your Morning WeightBody Fat % (if known)Height in Inches*Resting Heart Rate?*50-6060-7070-8080+Please describe your goal using the SMART model (specific, measurable, achievable, relevant, time-bound)Please give as much details as possible.*Why Is This Goal Important To You?*How Does Obtaining Your Goal Affect You/Others Around You? Include dedications, who will benefit once achieved, how things will change once achievedObtaining Your GoalFood Preferences Check all that applyFood Preference (if any)*I prefer higher proteinI prefer higher carbsI prefer higher fatsI dont have a preferenceHow Many Times a Day do You eat?*Describe Your Typical Pattern of Eating*Please list the foods/drinks you've consumed in the past 3-7 days *include at least one weekend day*Describe Your Relationship with food including any past eating disorders*Lifestyle & ExerciseHow Many Days a Week do you Workout?Describe Your Job*Very Inactive (office job)Semi Active (on your feet)Very Active (server)Extremely Active (hard labor, house cleaner)Have You Tracked Your food intake before?*yesnoWhat App Did You Use?*Do you track your steps (via fit bit etc) If yes how many average steps per day?*Describe your workouts.*Tell us weights, cardio, how many times per weekDescribe Your Experience with Tracking macros*Expert: Know the app like the back of my handPretty Good: Still have some learning to doFair: Have a lot to learnNon Existent: Never tracked beforeWhat supplements/medicines are you currently taking?*How many hours of sleep do you get?*What are your primary daily stressors?What do you do to relieve stress?How are your energy levels day to day?Is there any medical or psychological reasons why you shouldn't start a nutritional intervention program at this time?*Coaching StylesHow Restrictive Do You want to be? (select 1)*Very Restrictive/Fast PacedSemi Restrictive/Moderate PaceNot Restrictive/Slow PaceHow Do You Want to be Coached?*Tell It Like It Is (stern)Firm But UnderstandingA More Empathetic ApproachChoose Your Coach*Crystal CatalinaMatthew CookKatina CurranJesse DaleKelsey GirlieThomas HyltonAvery PaddockRoxanne VisWhat is the best thing to say to you if you need to be held accountable or want to quit on yourself?*Upload Your Starting Photos Here*Front/Back/Side if possibleMax. file size: 50 MB.CommentsThis field is for validation purposes and should be left unchanged. Δ