Sports Nutrition Intolerance Assessment Form
Help us assess your reactions to sports nutrition products and identify potential intolerances.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Age
*
What is your primary sport or physical activity?
*
How often do you engage in sports or intense physical activity?
*
Please Select
Daily
Several times a week
Once a week
Occasionally
Do you follow any specific diet or nutrition plan?
*
No special diet
Vegetarian
Vegan
Gluten-Free
Lactose-Free
Other (please specify)
Please indicate if you experience any of the following symptoms after consuming sports nutrition products (e.g., protein shakes, bars, gels):
*
Rows
Never
Rarely
Sometimes
Often
Always
Bloating
1
2
3
4
5
Stomach pain/cramps
6
7
8
9
10
Nausea
11
12
13
14
15
Diarrhea
16
17
18
19
20
Headaches
21
22
23
24
25
Itching or skin rash
26
27
28
29
30
Fatigue
31
32
33
34
35
Which of these ingredients in sports nutrition products have you noticed a reaction to? (Select all that apply)
*
Whey protein
Casein
Soy protein
Gluten
Lactose
Artificial sweeteners
Caffeine
Other (please specify)
On a scale of 1 to 10, how severe are your symptoms after consuming sports nutrition products? (1 = Not severe, 10 = Extremely severe)
*
Not severe
1
2
3
4
5
6
7
8
9
Extremely severe
10
1 is Not severe, 10 is Extremely severe
Have you ever consulted a healthcare professional regarding these symptoms?
*
Yes
No
Please provide any additional information or describe specific incidents related to your nutrition intolerance (optional)
Submit Assessment
Should be Empty: