In adulthood, when was the last time that you were at your target weight? *
Do you have difficulty losing weight despite best efforts? *
Are you currently following a ketogenic or low-cab diet? *
Do you have any dietary restrictions, allergies or intolerances or digestive issues? Please list them or write NA if this does not apply to you. (ie, vegetarian, lactose intolerant, IBS, gallbladder issues, etc.) *
Your answer
Do you have Diabetes? *
Are you taking any medications and/or have you been diagnosed with a medical condition that might interfere with weight loss attempts? *
When it comes to making lifestyle choices, if properly guided and supported by a coach, how would you rate your willpower or ability to stick to a plan? *