Nutritional Study Participant Screening
Full Name
Date of Birth
Gender
Female
Male
Other
Prefer not to say
Contact Number
Email Address
Health Information
Height (cm)
Weight (kg)
Medical Conditions (if any)
Current Medications (if any)
Food Allergies or Intolerances
Dietary & Lifestyle Information
Describe Your Typical Diet
Physical Activity Level
Sedentary
Lightly Active
Moderately Active
Active
Do You Smoke?
No
Yes
Do You Drink Alcohol?
No
Yes
Additional Comments