Client Dietary Information Form
This form is designed to collect important dietary information from the clients for the purpose of providing personalized nutrition recommendations and guidance.Please take the time to fill out the form as accurately and completely as possible, as this will help your dietician (Dt. Preksha Gandhi) better understand your individual needs and goals. All information provided will be kept strictly confidential.
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Name
Age
Current Complaints
Diagnosis/ Health issues, if any
Past history of any operation done
Height in cms
Current weight
Health goal/ Target weight you want to achieve
Email id
Country, City
Contact number
Preferred time for a call/ consultation
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