FREE Diet Analysis - It's FREE!
Carolyn Classick-Kohn,MS,RD

Succeed at your diet goals!
Get effective diet & nutrition help from experts... Get your diet program going in the right direction with our Free Diet & Nutrition Analysis. Your diet analysis will generate a personalized assessment of your needs. The output is designed & programmed by our expert's responses to a variety of diet & nutrition questions. The results are not complete and in no way should be viewed as a complete assessment but can help you understand some of the limitations of your current nutrition and/or diet regimen.

Learn how to improve your diet and overall health
Personal Dietitian's expert's give you a professional's viewpoint and the details you need to succeed. Join Personal Dietitian and excel at your diet and/or health goals. With your plan you can "Do-it-Yourself" or get expert help as needed!

About the Custom Diet and Nutritional Analysis
An overview of your diet and nutrition needs is given right away using the answers you give below. The answers to the questionnaire below will be automatically e-mailed to our dietitian. The information from your profile will be held for you should you consider joining and obtain a PersonalDiets™ program. Your profile is always kept confidential in our files and your information is never sold or used by anyone!

Start your FREE Diet Analysis below:

Personal Information

Name:

Email:

FREE Dieting Tips Newsletter:
Yes No

Physical Characteristics
Gender
Male Female

Height, in
Weight
Age

Exercise/Training...

1A. Check one answer that best describes your level of physical activity

Competitive athlete

Physically fit, non athlete, regular exercise routine

Recreational activity ("week-end athlete")

Limited physical activity - gardening, walking, cleaning but does some movement of that type daily

Sedentary - not active or bare minimum for daily needs such at weekly chores.

1B. Diet/Nutritional Goals

A. Reduce body fatYes No

B. Lose weight Yes No

C. Improve nutrition ( health reasons, for competitive body building, gain weight, lose body fat, etc)
YesNo

D. Improve overall appearance ( competitive body builders, models, weight loss)
Yes No

E. Increase energy and overall fitness
Yes No

2. Health Considerations:

1. Improve cardiovascular profile (Heart health-lower cholesterol, lower triglycerides-lower blood pressure)
Yes No

2. Heart Disease Yes No

3. High blood pressure Yes No

4 .High blood cholesterol YesNo

5. High triglycerides Yes No

6. Diabetes Yes No

7. Alcohol/substance abuse Yes No

8. Smoke tobaccoYes No

9. Taking prescription drugs regularly
Yes No

Women Only-
10. Pregnant
Yes No
11. Breastfeeding
Yes No