JCF One Time Macro Count Form

1Client Contact & Demographics

Required *

What is your name? *

What is your Email Address? *

Phone Number (optional)

What is your Age? *

What is your current Height and Weight? *

2Body Composition & Motivation

What is your current goal for body composition? Are you aiming to lose weight, shed body fat, or build muscle mass? Keep in mind that fat loss and muscle gain require different approaches, so let us know which is your top priority at the moment. Do you have a specific target in mind, such as a weight goal or desired changes in body fat percentage or muscle definition? The more specific you can be, the better we can tailor your macros to suit your needs! *

Why do you want to lose weight, reduce body fat or build muscle? *

3Health History & Work Life

Do you have any diagnosed health conditions, such as diabetes, high blood pressure, hypothyroidism, or others? If so, please list them along with how long you’ve been managing them. Providing detailed information helps us tailor your plan to your specific needs. *

Are you currently taking any medications and/or supplements? If yes, please list them below. *

What is your occupation or line of work? *

4Daily Activity & Steps

How would you describe your activity level during the day? *

None, sedentary lifestyle, little activity during the dayModerate, light activity during the dayActive, on your feet most of the day but nothing strenuousVery Active, on your feet and doing strenuous activity throughout the dayOthers

On average, how many steps per day do you take? *

In the above question, do you currently track your steps and know your daily average, or are you estimating? *

I track my steps, and the number provided is my daily average.I'm not tracking it precisely, just providing my best estimate.

5Exercise & Workout Routine

How many days per week do you exercise?

How many minutes of moderate-intensity exercise per week? *

What kind of exercise do you participate in (yoga, jogging, High-Intensity Interval Training, strength training, etc.)? *

6Macro History & Tracking

Do you currently count calories or macros?

Weight trend over past 3 months?

If you track your calories or macros, please share your current calorie/macronutrient targets, how long you've been tracking them, and the results you've experienced with these numbers.

Do you have any dietary restrictions, such as being vegan, vegetarian, or pescatarian? Are you allergic to any foods, or do you have any intolerances to gluten or lactose? *

7Hydration, Stress & Recovery

How much water do you typically drink per day? What other beverages do you consume often? (beer, soda, juice, coffee, energy drinks, wine, etc.) *

Do you consider yourself a stress or emotional eater? Please explain why or why not. *

Current stress levels (scale of 1-10)?

How much sleep do you get on average? *

8Past Experience & Struggles

What diets or nutrition programs have you tried in the past? What aspects were successful, and what didn't work for you? *

What do you struggle with most when it comes to nutrition? Is there one specific challenge that, if overcome, would make a big difference in helping you achieve your goals? *

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