Nutrition Plan | Sign up - Back in Balance

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Health and Wellness Goals

How would you rate your current eating habits on a scale of 1-5?

How often do you exercise in a week?

Dietary Preferences and Allergies

What do you think your ideal body weight is and/or how important is that number to you?

Are there any foods you absolutely dislike or refuse to eat?

Do you follow any specific dietary preferences?

Additional Information

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