Estimated Time: 20 minutes
Number of Sections: 6
This is the complete program registration form. It is meant to serve as a general evaluation tool and improve your program. You can skip questions you don't feel comfortable answering. However, the detail of your submission will have a direct impact the direction of the program.
Section 1 - General Health
Please answer the following question to the best of your ability:
List any current health issues you currently have (in order of importance):
Section 2 - Lifestyle
The following questions will evaluate various aspects of your lifestyle, please answer as accurately as possible:
Section 3 - Dietary Habits
Let's focus our attention to your food habits and see if there are any areas for improvement: