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HARDCORE HEALTH

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Based out of Eliot, ME

978-810-5734

hardcorehealthinfo@gmail.com

Meal Planning Questionaire

First name

Last name

Birthday

Month

Day

Year

I am willing to try new foods or meals or spices or cooking methods at least once.

Yes, I am willing!

No,I need my favorite meals included in my plan

If you need certain meals included in this plan because you already know you will eat them, please write them down here and I will plug them into the plan!

My diet is

Vegetarian with exceptions

Omnivore (plant and animal)

Paleo (strict)

Other

If Other, describe:

Special medical diet considerations, like low sodium, lower cholesterol, no gallbladder, Type 2 diabetic, etc...

Are you avoiding certain foods due to sensitivity/allergy? which foods? Gluten? Dairy? Soy? Nuts?

The additional fat sources I can and will eat:

Tree Nuts

Peanuts

Avocado

Cow Butter

Ghee

Coconut products

Olive products

Seeds

All the Fruit/sugar carbohydrates I can and will eat:

Banana

Berries

Citrus

Stone fruits

Melons

dried fruits

honey

Maples syrup

granulated sugars of any type

Juice

All the types of protein I will eat are

Cow Dairy

Goat/sheep Dairy

Dark Chicken

Light/ Lean Chicken

Beef

Pork

Whitefish

Salmon

Shrimp

canned tuna

Eggs/whites

Beans

Soy/tofu

vegan protein powder or shake

All the starchy carbohydrates I will eat are:

Potatoes

Squashes

White Rice

Brown/Wild Rice

Quinoa

Oats

Corn

Other hot grains like barley

Sweet potatoes

Wheat/Flour

Pasta/ GF pasta

All the vegetables I will eat are:

Crucifers:Broccoli,cauli...

Night shades like peppers, tomatoes

Cookable leafy greens like cabbage, kale, bok choy

Raw leafy greens like lettuce, spinach,sprouts

Root veggies,carrots, beets...

Any other veggies

Alliums like onion, garlic

Add any additional preferential information, like avoiding high sodium foods or spices, or if you just will never eat marinara.

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