One-time Macro Count Form

The Mindful Macros Count

Yesss, knowing what macros are the best for YOU is the first step in getting the body of your dreams. Your macro-breakdown (how much protein, fat, and carbs) you should be consuming is so much more important than just your calories. And because you are not like anyone else on this earth, you will have a different set of macros according to YOUR body and YOUR health factors. Please answer the questions with as much detail and context as possible so I can be sure I can help you to achieve your goals!! You will receive a confirmation email soon after submitting; make sure you schedule out consultation call where I go over it all with you and give you all my resources! I can't wait!!!!!
Name*

First NameLast Name
Phone Number

Area CodePhone Number
Birthday*

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Gender*

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Preferred Pronouns
Email*
example@example.com
Address

Street Address

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CityState / Province

Postal / Zip Code
Occupation
Current weight (in lbs)*
Height (in ft & in)*
Your Instagram handle*
Describe your health. Are you pregnant / trying to get pregnant ? Breastfeeding ? Do you have any injuries? Please include if you have had any surgeries, treatments, have any diagnoses, or anything that could contribute to your metabolic health (like having pcos, being insulin-resistant or being diabetic, hypothyroidism, hyperthyroidism, hashimotos, etc):*
Do you take any medicine on a routine basis (prescription or vitamins)? Please explain if so.*
Do you have any dietary restrictions? Allergies? What do you currently eat to get protein? Fiber? Are you vegan / vegetarian / pescatarian?*
Describe your activity on a weekly basis. Do you exercise? If so, what do you do for exercise? How often? In the gym, at home, outside? How many steps do you get a day (on average)? *
Describe your sleep. How many hours do you get on average per night? Do you have trouble falling asleep or staying asleep? What does your sleep schedule look like? *
How familiar are you with tracking macros? Are you currently tracking? How many calories are you currently eating ? How much protein and fiber are you aiming for / currently getting ? Any issues with tracking and being consistent ?*
What are your nutrition goals?

Fat loss / Weight lossMaintain weightBuild muscleHealthier habitsLower cholesterolImprove digestionRegulate hormonesOther
What set of macros would you like? (2nd set will automatically be at maintenance)*

For fat loss (caloric deficit / cut)For reversingFor building muscle (caloric surplus / bulk)
How did you find out about me?

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Would you like to receive a newsletter with tips on macro counting and living a healthy lifestyle?

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1-time macro count service*

1-time Customized Macro CalculationsThis is a one-time fee and includes two sets of macro calculations, one set for fat loss, reverse, or bulk and the other set to maintain. Included is a 60-min consult call to clarify any questions and give guidance on logistics (when to switch, how to hit your macros, common pitfalls, my tips and tricks, and my recipe e-book with over 40 macro-friendly recipes and grocery list). This is ideal if already know how to track your macros or you are willing to learn and you have the motivation and can be consistent without the guidance of a coach.

$497.00

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The Mindful Macros Count