1. Mac Users - Click & drag the form below to your computer desktop and save as a blank template. PC Users - Request a copy of this form by Email.
  2. Print 3 copies 
  3. Fill out daily for 3 days.  The value here is to reveal your food intake AS IS.  Resist the urge to eat differently than you normally do.  That is not the purpose. 
  4. Bring this completed form with you to your first Nutrition Consultation appointment.