Vegan Client Nutrition Assessment
Personal Information
Name
Date of Birth
Email
Phone
Address
Health Information
Height (cm)
Weight (kg)
Physical Activity Level
Sedentary
Lightly Active
Moderately Active
Very Active
Allergies
Medications/Supplements
Dietary Intake
Typical Meals and Snacks per Day
Any food dislikes or restrictions?
Vegan Diet Details
Fully Vegan
Occasionally Eats Dairy
Occasionally Eats Eggs
Mostly Plant-Based
Reason for choosing vegan diet
Any challenges with vegan diet?
Lifestyle & Goals
Main nutrition/health goals
Relevant health history (digestive issues, chronic illness, etc.)