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Weight Loss Specialist in women 35+
Medical Doctor | Msc Nutr | PT
Home
Coaching
Workouts
DES
Contacts
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Name
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First
Last
Email
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Phone number (with country code)
Date of birth
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Where do you live? (country, city)
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What is your occupation?
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Height (in cm)
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Weight (in kg)
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Waist and hips circumferences in cm
What is your goal?
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You can also write Short, Medium and Long-term goals (e.g. I wish to achieve… in 1, 6, 12 months)
Your issue story
If excess weight, when appeared, did you try any diets, workout programmes or other weight loss methods, etc.
Do you have any chronic diseases, which ones if yes?
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Did you have any operations, injuries, serious acute conditions, which ones if yes?
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Aren`t you in a special condition such as pregnancy or breastfeeding ?
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Did you give a birth, and how many times if yes?
What supplements do you take constantly? (name, dose)
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Do you take any medicines constantly? If yes please write the name and dose
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Do you have an allergy for any foods or supplements?
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Do you smoke (constantly)?
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How much water approximately do you drink a day?
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How many times a day do you eat?
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Write down here everything you ate yesterday or other usual day (time, what exactly, the amount)
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What is your meal style mainly? (I cook,my wife/husband/partner cook, I eat at the restaurants etc.)
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What is very hard to refuse for you? (for example – sugar, sweets, sausage, beer and so on)
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Describe your usual day plan (waking up time, work, exercising, going to bed time etc.)
Do you do any sports? If yes – since when, what exacltly and how many times a week?
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How long in minuts do you exercise, which level you think you are (e.g. beginner/intermediate/advanced)?
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What are your preferances in exercising?
E.g. “I like mat/floor/standing/chair workouts, or I like workouts with dumbbells/resistant bands, etc.”
Do you have any fitness equipment at home?
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Please here mention anything you would like to use in your Programme
What type of workouts you find too hard, or not good for you due to some health issues?
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For example, “I can`t bear high intensity/resistant/weights workouts, etc.”
What type of exercises you don`t want to be included in your Programme?
For example, squats/lunges/planks. Please, write anything you don`t like
Would you like to have music on the background of your videos or you prefer to turn your own tunes?
How you would like me to send your videos?
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Through Cloud/Transfer service (you will be able to download them to your computer, however videos won`t be available online)
Through YouTube (videos will be available from anywhere via links, but you won`t be able to download them)
Which source did you hear about me from?
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Google search
My YouTube videos
YouTube description to videos
Instagram
Recommendation
Other
If there are any blood tests or other examinations you have, please send them via WhatsApp/email
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