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1. Select the genre
Male
Female
2. What is your purpose?
Weight loss
I'm gaining pounds
3. Height (cm)
4. Weight (kg)
5. Weight you intend to lose / gain (kg)
6. Age
7. Do you have discomfort during the day in the stomach area? (after eating some food)
Yes
No
8. Can you stick to 4 meals a day?
Yes
No
9. Select certain habits from the following:
I can't give up sweets
Consuming fruit or fresh juices
I eat fatty food
Frequent alcohol consumption
10. Do you work out?
Yes
No
11. Do you feel sleepy in the afternoon?
Yes
No
12. How much time do you have available for preparing meals?
30 minutes
45 minutes
1 hour
13. How often do you eat in a restaurant?
Rare
1-3 days a week
1-3 days per month
14. Allergies?
Yes
No
15. You are:
No fish
No pork
Gluten free
Lactose free
16. Diabetes?
Yes
No
Last name
*
First name
*
Phone
*
Email
*
Additional details
Send
After pressing the submit button, you will be redirected to choose your plan!
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