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Lifelicious
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Intake form
Help us serve you better
Name
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Email address
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What are your primary health goals?
Please select at least one option.
Weight loss
Muscle gain
Improving overall health
Managing a medical condition
Enhancing athletic performance
Boosting energy levels
Do you have any dietary restrictions?
Please select at least one option.
Vegetarian
Vegan
Gluten-free
Dairy-free
Nut-free
What is your current level of physical activity?
Select
Sedentary
Lightly active
Moderately active
Very active
Athlete
How many meals do you consume in a day?
Select
1
2
3
4
5 or more
What type of cuisine do you prefer?
Please select at least one option.
Indian
Continental
Asian
Mediterranean
Healthy Snacks
Do you have any specific food preferences?
Are you currently following any specific diet plan?
How did you hear about us?
Select
Social media
Google search
Friend or family
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Which service or services are you interested in?
Please select at least one option.
Dietician consultations
Customized nutritional meals delivery
Nutritional guidance workshops
Additional questions or comments
Please confirm that you are not a robot.
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