Nutrition Assessment Form

Personal Details

Height and Weight History

Nutrition and Fitness Goals

Medical History

Females Only

Health Information

Exercise Information

Please specify what exercises/sport/training you typically do each day (please provide as much detail as possible):

Nutrition Log

Please list out what a typical day of eating looks like for you.

Please be very specific, including times, portion sizes and brands (i.e. 1 Latte made with whole milk, 45g Porridge oats etc…).

Do not forget to include drinks.


Morning Snack


Afternoon Snack


Evening Snack

Eating Habits