Questionnaire Which MD Diet Plan is right for you? Fill out the form below to see what kinds of results you could expect from a personalized MD Diet plan. "*" indicates required fields Do you have any dietary restrictions? (allergies not included)* No Meat, Fish & Eggs OK Dairy OK, No Meat No Fish No Meat - Seafood OK None What best describes your goals:* Maintain weight, build muscle + lose fat Lose weight How frequently/ intensely do you exercise?* I don’t exercise Just walking Regular moderate exercise classes, cardio, resistance Frequent and intense Email Consent I agree to receive emails . Do you have any of the following health issues or history (select all that applies):* None Any Cancer Kidney Disease or Renal Issues No Gallbladder Crohn’s disease How have you gained weight what do you think applies most to your circumstances:* Too busy, skipping meals, making poor fast food choices High stress and emotional eating Hormonal change or regulation issues How fast do you want to lose weight?* As quickly as possible Standard Aggressive Weight Loss - 2 lbs a week Moderate Healthy Fat Loss - 1 lb a week Have you ever been on a diet before? Yes No What do you prefer to eat? I love lots of protein supplements and lean meat I prefer satiating high fat foods Δ
