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NEW CLIENT NUTRITION AND PEPTIDE COACHING INTAKE FORM
1. BASIC PROFILE
Date Completed
*
Name
*
Age
*
Sex
*
A
Male
B
Female
Height
*
Current Weight
*
Goal Weight, if applicable
Current Waist Measurement
Current Body Fat %, if known
Current Lean Muscle Mass, if known
Have you completed an InBody, DEXA, or other body-composition scan recently?
A
Yes
B
No
If yes, record the relevant measurements below
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