Order a Personalized Nutrition Plan

Personalized Nutrition Plan Questionnaire

100% Human Expertise, Zero AI

Your Plan is Created by a Nutrition Expert

Your personalized nutrition plan will be carefully crafted by our qualified nutrition expert - not by artificial intelligence or automated software.

Biljana Svrzic

Nutrition Expert

After you complete our questionnaire, our expert personally reviews your answers, health goals, lifestyle, and preferences. She then uses her advanced degrees and years of hands-on experience to create a nutrition plan that’s specifically designed for you.

Why does this matter?

Real understanding of your unique situation and challenges
Personalized recommendations based on professional judgment
Flexibility to adapt plans as your needs change
Expert insight that goes beyond generic formulas

No shortcuts. No algorithms. Just expert care.

Your health deserves the attention of a qualified professional, not a computer program. That’s our promise to you.

Personalized Nutrition Plan Questionnaire

25%

Contact information

First Name*

Last Name*

Email Address*

Phone number*

Biological sex*

Male

Female

Prefer not to disclose

Year of birth*

Height*

Units*

feet/inch

Weight*

Units*

lbs

Waist circumference*

You will need: measuring tape (flexible meter) or string + ruler
1. Stand upright and exhale completely
2. Measuring - Wrap the meter or string around the waist, at belly button level and mark the place where it meets
3. Read the measurement from the meter or measure the string with a ruler
Important: The meter/string should be firmly against the skin, but must not squeeze or indent the skin

Hip circumference*

You will need: measuring tape (flexible meter) or string + ruler
1. Stand uprigh with your legs slightly apart 2. Find the top of your hip bones 3. Measuring - Wrap the tape around your hips or string around your thigh and mark where it meets 4. Read the measurement from the meter or measure the string with a ruler
Important: The meter/string should be firmly against the skin, but must not squeeze or indent the skin

Circumference of the widest part of the upper arm*

You need: measuring tape (flexible meter) or string + ruler
1. Relax your arm beside your body or bend it slightly at the elbow
2. Find the widest part - usually in the middle between shoulder and elbow
3. Measuring - Wrap the meter or string around the upper arm and mark the place where it meets
4. Read the measurement from the meter or measure the string with a ruler
Important: The meter/string should be firmly against the skin, but must not squeeze or indent the skin

Circumference of the widest part of the thigh*

You will need: measuring tape (flexible meter) or string + ruler
1. Stand upright with legs slightly apart
2. Find the widest part - usually at the top of the thigh, just below the groin
3. Measuring - Wrap the meter or string around the thigh and mark the place where it meets
4. Read the measurement from the meter or measure the string with a ruler
Important: The meter/string should be firmly against the skin, but must not squeeze or indent the skin

What do you hope to achieve with this program?*

Are you trying to lose or gain weight?*

Lose weight

Gain Weight

I just want to eat healthier

What is your goal weight*

Units*

lbs

Health condition

Chronic diseases*

Chronic diseases, list therapy you take and how you take medications

List all supplements that you use

Vitamins, minerals, herbal / homeopathic preparations, extracts, teas...

General conditions without specific therapy

Problems with digestion, intestines, headaches, insomnia, tendencies towards certain diseases, insulin resistance, nervousness, fatigue, pregnancy/breastfeeding, rheumatic problems, etc...

Surgeries or other surgical procedures in the last 6 months

Lifestyle habits and daily routine

Daily obligations and other activities

(e.g. shift work, how long they last and when during the day, time spent at home, rest periods, specify duration of exertion and rest during the day in as much detail as possible)

Do you currently exercise?*

Yes

What type of exercise / training / sports activity?

How many times/days per week?

How long? (minutes per day)

Do you have any exercise limitations?*

Yes

Describe what exercise limitations you have.

Sleep rhythm

Have you ever deliberately induced vomiting, used laxatives, fasted, or exercised for long periods of time to lose weight? If yes, please explain.

Regular bowel movement (every day)

Yes

Mostly yes

Mostly no

Eating Patterns

The type of diet you follow*

Specify the type of diet you follow

How many meals do you usually eat per day?*

0-1

2-3

How many snacks do you usually eat per day?*

0-1

2-3

How often do you skip meals?*

Never

Seldom

Sometimes

Often

Always

List the foods that you absolutely do not consume due to your health condition, food intolerance or allergy?*

Name the foods you like to consume?*

Name the foods you don't like to consume?*

What type of beverage do you like?

What are your beverage dislikes?

Alcohol consumption?

How much water do you drink per day (8 oz cups)?

On average how many cups (8oz.) of caffeinated beverages do you drink per day?*

(black tea, coffee or energy drinks)

On average how many cups (8oz.) of sugary drinks do you drink per day?*

(soda, sports drinks, juices)

On average how often do you snack on convenience food*

(chips, candy, granola bars, crackers, cookies)

Never

Seldom

Sometimes

Often

Always

Who does the meal preparation and cooking?

I prepare meals.

Somebody else

Which of the following factors apply to your eating habits and current lifestyle? Check all that apply*

Mark everything that applies to you.

Likes healthy food

Fast eater

Rely on packaged/fast food

Plans meals

Do not plan meals

Late night eater

Lives alone/eats alone

Eats most meals at table

Reads nutrition labels

Knows how to cook

Prepares meals at home

Eats a variety of foods

Are you a smoker?*

Yes

Additional information of importance, which you did not state earlier?

This field should be left blank

Personalized Nutrition Plan Questionnaire

Your Plan is Created by a Nutrition Expert

Biljana Svrzic

Why does this matter?

No shortcuts. No algorithms. Just expert care.

Personalized Nutrition Plan Questionnaire

Contact information

Health condition

Lifestyle habits and daily routine

Eating Patterns

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