Meal Planning Questionnaire

This questionnaire should only take 10 to 15 minutes to complete. Please provide as much information you are comfortable with. All fields are required so we are able to fully understand your needs and goals. The contents of this questionnaire is confidential. – Chef Thomas

I am looking forward to working with you on your goals!

26. We would like to get a good sense of what you are currently eating so we can provide you with the best guidance. Please include beverages and how many ounces of water you drink each day.

Sample Food Journal

Day 1

  • Breakfast 6am: Large coffee with cream, plain bagel, cream cheese
  • Snack 10am: Low-fat greek yogurt with blueberries
  • Lunch 1pm: PBJ on wheat bread, bag of chips, Diet Coke
  • Snack 3pm: Coffee with cream, small oatmeal cookie
  • Dinner 8pm: Small caesar salad, 2 pieces of pepperoni pizza, 2 beers
  • Water throughout the day: 2 water bottles = 40 ounces

Day 2

  • Breakfast 6m: Large coffee with cream, plain bagel, cream cheese
  • Snack 10am: Low-fat greek yogurt with strawberries
  • Lunch 12pm: Sushi: 6 spicy tuna rolls, 6 salmon/avocado rolls, miso soup, iced green tea with lemon
  • Dinner 7pm: Grilled chicken burrito from Burrito Box, chips and salsa, lemonade
  • Snack 8pm: 1/2 pint Haagen Dazs coffee frozen yogurt
  • Water throughout the day: 2 water bottles = 40 ounces