TinLaneCo Nutrition Questionnaire
This is designed to assist in designing your optimal food plan
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Email *
ABOUT YOURSELF
Add detail, so that I can understand a little bit more about you
Name, Age, Location, Telephone number *
Bit about yourself, please.
Past Medical History *
Medications *
Have you worked with a nutritionist before?
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What is the reasoning for choosing TinLaneCo? What do you want to get out of it?
What areas do you see as ones you can work on?
Any wearable technology and training apps/software you currently use to track, monitor, manage your training & health?
BASELINES
Having some objective measures is KEY to making progress that matters
Have you had a DEXA scan or other body composition assessment? (if yes, send thePDF results through)
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Waist Circumference Measurement (the narrowest part of your waist)  INCHES *
Your height *
Current Weight and Goal Weight *
EXERCISE & ACTIVITY
Please let me know what you currently do for exercise and training
Describe your current level of fitness? *
Describe your training experience? *
Describe your over-riding goal? *
Are you a member of a gym?
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If no, do you envisage joining a fitness establishment?
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If no gym membership. Will you be working out from:
If not being able to access a fitness facility do you have access to any fitness equipment such as:
Your current hours of exercise per week (take the time to accurately work out what you actually do, not what you think you do, please) *
How many days a week can you realistically commit to spending on 'fitness' activities?
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Currently how many strength sessions are you doing? *
On average how many minutes do you spend on Weights per session?
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How many steps do you average per day? If you have a smart phone, it will tell you.
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How many cardio sessions do you do per week?
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On average how many minutes do you spend on Cardio per session?
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Is there a body part/area that you want an additional focus towards?
Are you currently working with a personal trainer/S&C coach?
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What type of exercise do you do?
Tick the movements you are proficient at completing in the gym? *
Required
Any exercises you do not do or cannot do? *
Do you have a training partner?
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FOOD & NUTRITION
This lets me understand your habits a little bit better.
My food preference is: *
These are the foods I prefer to eat for breakfast *
Required
These are the foods I prefer to eat for lunch & dinner *
Required
These are the foods I prefer to eat for snacks *
Required
My weakness is......
These are the foods I dislike or refuse to eat *
I have a real food allergy *
Required
I get adverse symptoms (bloating, coughing, reactions etc) from these foods *
Required
I take the following supplements *
Required
I am happy to weigh food (at least initially) to gain an understanding of portion size? *
I prefer simple recipes that are quick and easy? *
I use online grocery shopping weekly *
I often find I run out of food in the house by the end of the week *
LIFESTYLE
Alcohol, sleep and caffeine
Alcohol - what, how often and how much do you drink?
Do you have difficulty sleeping?
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How many hours on average do you get per night?
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How many cups coffee per day do you drink?
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What is the latest time you drink coffee?
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Anything you want to add to assist the process?
A copy of your responses will be emailed to the address you provided.
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