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+852 51974668

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BUY YOUR SESSIONS HERE USING PAYPAL
 Acceptance Mark

 

 

EVALUATION FORM

There is the oportunity to fill in a detailed evaluation form for me to study...

This is in order for me to really deduce what your body needs and what your body needs to avoid. I can then formulate a personally catered physical and nutritional regime for you to follow...

There are just a few questions to fill in first... the majority of which are optional.

Contact Details
Name*
Email*
Telephone

Personal Details
Profession
Age
Gender
Male
Female
Blood Group
Height
cm (183cm = 6')
Weight
kg (1kg = 2.2lb)
Metabolism
High
Medium
Low

Typical Daily Schedule

Please give a rough outline of what you put yourself through during your working day... breakfast, morning activities, lunch and what you get up to in the afternoon and evening.
Breakfast
Morning
Lunch
Afternoon
Evening Meal
Evening

Food Groups Often Eaten
Meats
Fish
Fruit
Vegetables
Carbs
Cereals
Snacks
Drinks
Alcohol

Healthometer
Energy Levels
Always Bursting
Generally Good
High and Low
Often Flag
Immune Health
Rarely Sick
Twice Yearly
Often On Meds
Immune Failure
Fitness Levels
Very Fit
Active
Rarely Exercise
Unfit

Additional Comments