Personalised Meal Plan Intake Form

General Information

First Name *

Last Name *

Gender *

Age *

Email Address *

Mobile phone (Optional)

How did you find out about us?

What is your Goal?

My Goal is

Anthropometry

Weight (kg) *

Height (cm) *

Physical Activity

Current Physical Activity Status *

Sedentary (Little or No Exercise, you spend most of the day sitting)Lightly Active (Light exercise or sports 1–3 days/week Includes daily activities like walking, house chores)Moderate exercise (Sports 3–5 days/week eg.Regular gym sessions, running, cycling, brisk walking )Very Active (Hard Exercise 6-7 days/week includes manual labourers or athletes training most days of the week)Extra Active (Very Intense Exercise + Training, Eg: Construction workers, elite athletes, or those doing 2* day training)

Health Information

What do you want the Meal Plan for? *

Mention any medical condition you have? *

Please list any allergies and Intolerances

Allergy

Intolerance

Please list any Medications and Supplements you are having

Medication and Dose *

Supplements (Best to specify brand and dose)

Do you smoke?

YesNoI used to smoke

How much water do you have in your day?

1Lless than 1L1.5L to 2L2L to 3L

Tell us about a typical day of eating.

Weekday Example (Mon-Fri) *Include times if possible (e.g., breakfast, snacks, lunch, dinner, drinks)

Weekend Example (Sat-Sun) *Mention any changes in timing, food choices, or portions.

Other Comments

Meal Plan Preference

Everyone’s routine is different! To help us personalise your plan, how would you prefer your daily meals to be structured?

3 meals and 2 snacks (e.g., breakfast, lunch, dinner + mid-morning and afternoon snacks)2 meals and 2 snacks (e.g., brunch and dinner + 2 snacks)3 meals, 2 snacks, and a light supper (e.g., dinner is early and you need a small evening bite)

Cooking & Meal Prep Habits

How confident do you feel in the kitchen? *

I’m very confident and enjoy trying new recipesI can cook basic meals and follow simple recipesI prefer minimal cooking or ready-to-eat options