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Nutrition Coaching Exit Survey
PERSONALIZED NUTRITION PLAN: Please fill out the following survey. When you submit the survey, you will be directed to our MindBody site to purchase your Personalized Nutrition Plan. Once your purchase has been verified, you'll receive your Personal Plan within 48 hours.
Indicates required field
Time frame estimate: (this will vary slightly based on how far you have to go)
Comfortable (roughly 16-32 weeks)
Reasonable (roughly 8-16 weeks)
Extreme (4-8 weeks)
Very light (almost no purposeful exercise)
Light (1-3 hours per week of gentle exercise)
Moderate (3-4 hours per week of moderate exercise)
Intense (4-6 hours per week of moderate to intense exercise)
Very intense (7+ hours per week of strenuous exercise)
What are your nutrition goals?
Daily activity levels (work and/or home)
Very light (sitting most of the day, such as a desk job)
Light (mix of sitting, standing, light activity, such as a teacher)
Moderate (continuous gentle to moderate movement, such as a server)
Heavy (strenuous activity, such as a construction worker)
How many times would you like to eat per day?
SHAKTI FIT YOGA AND TRAINING STUDIO
14 E. Gambier St Mount Vernon, OH 43050
YOGA. TRAINING. NUTRITION.
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