IRON FORK NUTRITION
Programs
Packages
Fitness
Nutrition
Alpha Series
Recipe Books
Merch
Success Stories
About
Purchase Information
*
Indicates required field
Order number
*
The order number can be found in your confirmation email.
Personal Information
Name
*
First
Last
Email
*
Phone Number
*
AGE
*
Height
*
Weight
*
Gender
*
Male
Female
Body Fat Percentage
*
If you know your current body fat percentage, input it here as a percent
Goals
What are your physical goals?
*
What are your health goals?
*
Why do you have these goals?
*
Have anything else you would like us to know? If so, fill it in here!
How do the people around you support these goals?
*
How motivated are you to reach these goals?
*
How willing are you to put in the work to reach these goals?
*
Do you see any hurdles that may prevent you from reaching these goals?
*
Do you have access to a gym?
*
Yes
No
How many days per week are you able to make it to the gym?
*
1 Day
2 Days
3 Days
4 Days
5 Days
6 Days
7 Days
Habits
On a scale from 1 to 10, rate your current eating habits
*
1
2
3
4
5
6
7
8
9
10
1 is Very Unstructured 10 is Very Structured
Do you normally eat breakfast?
*
Yes
No
Sometimes
How many meals do you normally eat per day?
*
Where do you struggle when it comes to dieting?
*
Don't know what to eat
Don't know how much to eat
Overeating
Uncontrollable hunger
Mindless snacking
Overconsumption of alcohol
Emotional eating
Sweet tooth
Intense cravings
Under eating
Low appetite
Too busy to eat
Select all that apply
How many times per week do you cook your own meals?
*
1-3
4-6
7+
Have you tried any diets in the past?
*
Yes
No
Did any of your past diets work? Why or why not?
*
Are you comfortable counting calories?
*
Yes
No
Are you comfortable counting macros?
*
Yes
No
Lifestyle
How many hours per week do you spend engaging in some type of exercise?
*
If you work outside of the home, how physically demanding is your job?
*
Not at all (desk job, driving)
Slightly demanding (on your feet/walking)
Moderately demanding (warehouse work)
Very demanding (hard labor)
Health
How would you rate your current health?
*
Do you have any physical limitations?
*
Do you have any relevant current or past health issues?
*
Do you have any health concerns you would like to address in this program?
*
Do you have any allergies or food sensitivities? If so, what?
*
What are some of your favorite foods?
*
What are your least favorite foods?
*
Keeping in touch
I will be communicating with you through text message most commonly.
Another method I like to use to communicate with you is a walkie-talkie app called Marco Polo. It's free and can be found on in the app store on both iOS and Android devices.
Submit
Programs
Packages
Fitness
Nutrition
Alpha Series
Recipe Books
Merch
Success Stories
About