Fill Out This Questionnaire Please answer this list of questions in order for us to help you achieve your goal. Name* First Last Phone*Email* What is your reasoning or goals to contact us?*What times are your meals and snacks?*How often do you exercise and what kind of exercise do you do?*What allergies do you have?*What is your Height and Weight?*How much water do you drink each day?*What medications do you take and why?*What if any diseases do you have?*How much if any alcohol do you drink and how often*Do you smoke?*Do you do any recreational drugs?*How often do your bowels move?*How many hours do you sleep in a day and what times?*What foods do you refuse to eat (if any)?*What is a typical day like for you?*