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1-1 Performance Nutrition Coaching
Thank you for your interest in helping to enhance your
performance!
This form is meant for those serious about 1-1 nutrition coaching and willing to commit to at least a 3 month program. Please include as many details as possible so that we can learn more about you. We'll follow up with an individualized proposal for your program length and number of sessions. If you don't hear from us within 72 business hours, be sure we didn't land in your spam folder
(
maria@mariarowenutrition.com
).
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Email
*
Your email
What is your name?
*
Your answer
Where did you hear about Maria Rowe, RDN, LD, CPT?
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Your answer
What sport(s) do you participate in? (include position if applicable)
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Your answer
Please indicate your age. If you are a student athlete, please indicate whether you participate as a high school or college athlete.
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Your answer
What performance related nutrition goals are you hoping to achieve with assistance from our sports dietitian?
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Your answer
What does your current training program look like and what period of training are you in (pre-season, competitive, off-season)?
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Your answer
Does you experience any of the following?
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frequent injury / high injury risk
inadequate recovery from necessary training program
excess fatigue
uncontrollable urges to eat
frequent illness (cold, respiratory infections, GI bugs, etc)
irregular menstrual function or infertility (females only)
low libido (males or females)
Other:
Required
If you checked off any of the above, please elaborate so we can better develop personalized recommendations for you. Ex: Are you currently injured? What injury do you have a history of? What is your current menstrual cycle and how long has it been this way (females)?
Your answer
If you've attempted to improve your nutrition or reach the above goals before, what approaches have you taken? Have you followed any diets or programs, and if so, which? For example: keto, low carb, macro counting, fasting, etc.
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Your answer
Have you worked with a registered dietitian before?
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Yes, another sports dietitian
Yes, but not a sports dietitian
No
Unsure
Please list your general availability to meet with a sports dietitian. Rather than specific dates, include days of the week/weekend as well as blocks of time, including your time zone.
Your answer
Nutrition is part of your training. Working with a sports dietitian requires commitment not only in your meetings and check-ins, but also as you apply what you learn to your daily life. Are you willing to make this commitment?
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Yes
No
Unsure
Is there anything else you'd like us to know that may help in determining the appropriate length and number of visits in our proposal for your starter program?
*
Your answer
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