Dr. Rizvi's Form to know you better

1. Name:

2. Age:

3. Gender:
MaleFemale

4. Current Weight (kg or lbs):

5. Target Weight (kg or lbs):

6. Body Measurements (optional)

• Chest:

• Waist:

• Hips:

Diet Preferences

7. What do you like to eat for breakfast?

8. What do you like to eat for lunch?

9. What do you like to eat for dinner?

Food Preferences

10. What fruits do you like?

11. What vegetables do you like?

12. What foods do you dislike?

13. What vegetables do you dislike?

Health Information

14. Do you have any medical conditions or allergies I should know about?

15. Do you follow any specific diet plan before? (e.g., Keto, Vegan, etc.)

Exercise Information

16. Any type of exercises you can’t do or anything I should know?

Contact Information

17. Email Address:
18. WhatsApp Number: