Online plan questionnaire - KCG Plataforma Clientes

Full Name *

Date of Birth *

Day *

Month *

Year *

E-mail address *

Current weight in Kilos(Kg) *0 / 200

Height in Centimeters (Cm) *0 / 200

Profession *0 / 200

Send current photos: Front, Back, Profile (side view) *Pictures should be taken with muscles relaxed. *

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How many days do you train per week (normally)? *

How many days a week do you train (on vacations)? *

Do you train alone or with someone? *0 / 500

What is your short-term goal? *0 / 500

What is your medium-term goal?0 / 500

What is your long-term goal?0 / 500

Have you ever used hormones, steroids or anabolic steroids, and do you intend to use them* (For women - If you use the birth control pill, please state so). *0 / 1500

Do you take any medication? Answer YES or NO. If your answer is YES: What medication, what do you use it for, dosage, how long have you been using it? *0 / 1500

Do you have health insurance? *0 / 500

Have you had any surgery? *0 / 500

Do you have any medical illnesses/injuries or restrictions? *0 / 500

Describe how you currently train. How many days a week, how much time per day (schedule in hours/minutes)? *0 / 1500

Do you have difficulties performing any specific exercise?0 / 500

Have you ever been on a diet? *0 / 500

Do you want to use supplements? If so, indicate how much money you can invest monthly in supplements. *0 / 500

How much money can you invest in food on a monthly basis? *0 / 500

Do you know how to cook and prepare food? *0 / 500

Does your schedule allow you to eat solid meals regularly? If not, explain why not. *0 / 500

Indicates foods that you cannot or do not want to eat.0 / 500

Indicate the foods to which you are allergic. If you are not allergic to any food, put NONE. *0 / 500

Describe to me your complete daily routine. *0 / 2000

Describe your meals (Amounts, Schedule, What meals do you have the hardest time eating, When are you most hungry, When are you least hungry). *0 / 2000

Can you continue with the diet on weekends? *0 / 500

How did you find me? *0 / 500

Below you will have a list of foods. You have to give them a score between 5 and 10.

5 means- I don't like this food/can't buy this food and don't want it in my diet.

10 means- I can use this food in any meal because I like it/can buy it.

PROTEINS

Chicken Breast *

Turkey Breast *

Red Meat *

Tuna *

Ham *

Cheese *

Eggs *

Tilapia(White Fish) *

Whole Milk *

Skimmed Milk *

Soy Milk *

Almond Milk *

CARBOHYDRATES

White Bread *

Whole wheat bread *

White Rice *

Brown Rice *

Sweet Potato (Boniato) *

Normal Potato *

Zucchini Spaghetti *

Yucca *

Oats *

Macaroni *

Rice Cream *

Corn *

OTHER

Yogurt Zero *

Kefir *

Banana *

Pear *

Apple *

Lentils *

Beans *

Pineapple *

Watermelon *

Papaya *

Melon *

Strawberry *

Blueberries *

Red Fruits *

Almonds *

Peanuts *

Walnuts *

Avocado *

Bacon *

VEGETABLES

Carrot *

Chard *

Celery *

Eggplant *

Mushrooms *

Cabbage *

Endives *

Peppers *

Radish *

Watercress *

Spring onions *

Turnips *

Leeks *

Onion *

Artichokes *

Brussels sprouts *

Broccoli *

Asparagus *

Tomato *

Zucchini *

Pumpkin *

Cucumber *

Cauliflower *

Peas *

Beans *

Lettuce *

Spinach *

Green Salads (Salads made with vegetables such as cucumber, lettuce, etc.). *

Beets *

Zero Jelly *

REMARKS:

Onions, garlic and natural seasonings you can always use. Avoid precooked dishes

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