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Midlife Diet Diagnostic

Welcome!


Please complete the following form so I can get started with your Midlife Diet Diagnostic!

At the end of this form, I'll ask you to upload a Word or Google Doc with a 3-day diary (I prefer 2 weekdays and 1 weekend day to give me a more complete picture to work with).

Please include:
  • All food plus the time of day consumed
  • Time of waking and going to bed
  • If you exercise, please provide the time of your exercise
  • Any supplements your currently take
Name(Required)

Please upload your document containing the items requested at the beginning of this form.

If you use a tracker like MyFitnessPal, you're welcome to share that data with me directly at mary@fuelbetterformula.com.

Max. file size: 64 MB.