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Begin Your Nourish Blueprint

This questionnaire gathers the information needed to create your personalized nutrition plan.
 

The Nourish Blueprint is a one-time investment of $247 and is designed to be followed and repeated over a 90-day period.
 

Please answer thoughtfully and honestly.

THE NOURISH BLUEPRINT

Intake Questionnaire

Health & Body Context

This information helps ensure your Nourish Blueprint

is built appropriately and responsibly.

Which best describes your current goal direction?

Life Stage & Context

This helps create a plan that supports your current season of life.

Which best describes your current life stage? (Select all that apply)
Do you notice changes in appetite, energy, or cravings throughout the month?

Goals & Focus

Understanding your primary focus helps shape your Nourish Blueprint.

What are your primary nutrition goals right now? (Select all that apply)

Daily Routine & Eating Pattern

Your current schedule helps determine meal timing, structure, and overall plan design.

How would you describe your current daily schedule?
What does your current eating schedule look like most days?

Movement & Activity

This helps determine overall intake and recovery needs.

How many days per week are you intentionally active?
0-1 days
2-3 days
4-5 days
6+ days

Nutrition Experience

Understanding your history helps create a realistic plan.

Have you followed a structured nutrition or macro-based plan before?
Yes, consistently
Yes, on and off
No, this is new to me
What has felt hardest to maintain in the past? (Select up to two)

Food Preferences

Your plan should feel realistic and aligned with what you’ll actually eat.

How do you feel about repeating meals throughout the week?
I prefer repetition
I’m okay with some repetition
I prefer variety

Readiness & Commitment

The Nourish Blueprint is designed to be followed and repeated over a 90-day period.

Does committing to a 90-day structure feel realistic for you right now?
Yes
Mostly
I'm unsure
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