Feed My Belly Meal Plan Intake
Please answer as honestly and completely as possible — your answers are how we build a plan that actually works for your life and your goals.
Note: This service is not a substitute for medical advice. Please consult your doctor before making significant dietary changes, especially if you are managing a medical condition or taking medications.
Which of the following are health goals for you? Check all that apply.
Weight & Body Composition
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Weight & Body Composition
Heart & Metabolic Health
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Heart & Metabolic Health
Gut & Digestive Health
Hormonal & Women's Health
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Hormonal & Women's Health
Lifestyle & Prevention
What are your TOP 3 health priorities right now?
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What has prevented you from reaching your health goals in the past?
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This section only applies if weight loss or body composition is one of your goals.
What is your current weight?
What is your goal weight? (optional)
How would you describe your current activity level?
How would you describe your current activity level?
How would you describe your current diet?
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How would you describe your current diet?
How many meals do you typically eat per day?
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How many meals do you typically eat per day?
Do you currently snack between meals?
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Do you currently snack between meals?
Do you meal prep in advance?
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Do you meal prep in advance?
How many times per week does your family typically cook dinner?
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How many times per week does your family typically cook dinner?
How do you typically handle leftovers? Check all that apply.
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How do you typically handle leftovers? Check all that apply.
Food Preferences & Dislikes
Do you have any food allergies or dietary restrictions?
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Do you have any food allergies or dietary restrictions?
Please list your food allergies or dietary restrictions
Which cuisines do you enjoy? Check all that apply.
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Which cuisines do you enjoy? Check all that apply.
Are there any cuisines you dislike or want to avoid?
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How would you describe your flavor preferences? Check all that apply.
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How would you describe your flavor preferences? Check all that apply.
Which of these meal styles do you enjoy? Check all that apply.
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Which of these meal styles do you enjoy? Check all that apply.
Are there any foods you strongly dislike or refuse to eat?
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Are there any foods you love and would be happy to eat regularly?
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Are you open to trying new foods and recipes?
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Are you open to trying new foods and recipes?
Any cultural or religious food preferences we should be aware of?
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Who are you cooking for?
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How many adults will this meal plan feed?
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How many adults will this meal plan feed?
How many children will this meal plan feed?
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How many children will this meal plan feed?
What are the ages of your children? (so we can make sure meals are kid-friendly)
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How picky are your kids when it comes to food?
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How picky are your kids when it comes to food?
How much time do you have to prepare meals on a weekday?
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How much time do you have to prepare meals on a weekday?
How much time can you dedicate to meal prep on weekends?
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How much time can you dedicate to meal prep on weekends?
How would you describe your cooking skill level?
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How would you describe your cooking skill level?
What equipment do you have? Check all that apply
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What equipment do you have? Check all that apply
What is your approximate weekly grocery budget?
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What is your approximate weekly grocery budget?
Do you shop at any specific stores or have limited access to certain stores?
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Just one last question — we promise! 😄
Is there anything else you'd like us to know about your health, your life, or your goals that hasn't been covered above?
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