Wholefood Nutrition Course Questionnaire « Anthia Koullouros – Ovvio Organics

OVViO ORGANIC health & lifestyle store
ANTHIA KOULLOUROS naturopathic clinic

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2 Heeley Street Paddington
NSW 2021 T: 02 9380 7863

Address 2 Heeley Street Paddington NSW 2021
Telephone 02 9380 7863	Fax 02 9380 7879
Email anthia@ovvioorganics.com.au

Retail Hours:
Monday - Friday : 9am-6pm
Saturday : 9am-5pm
Sunday : 10am-4pm
Clinic Hours: by appointment

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Wholefood Nutrition Course Questionnaire

Wholefood Nutrition Questionnaire & Diet Diary

Full Name(required)
Address
Email(valid email required)
Tele (home)
Tele (mobile)
DOB
Occupation
How did you hear about me?
In as much detail as possible please tell me what you would like to learn from me or what you are confused about in the realm of food and nutrition

Day 1

What time do you wake up?
What do you do between wake up and breakfast?
What do you eat for breakfast?
How long does it take you to get to work, take kids to school or get to other activities?
What time do you start work?
What do you eat for morning tea?
What do you do between morning tea and lunch?
What do you eat for lunch?
What do you do between lunch and afternoon tea?
What do you eat for afternoon tea?
What time do you get home?
What do you do when you get home? Cook dinner, shop, do more work?
What do you eat for dinner?
What do you do between dinner and sleep?
What time do you go to bed?

Day 2

What time do you wake up?
What do you do between wake up and breakfast?
What do you eat for breakfast?
How long does it take you to get to work, take kids to school or get to other activities?
What time do you start work?
What do you eat for morning tea?
What do you do between morning tea and lunch?
What do you eat for lunch?
What do you do between lunch and afternoon tea?
What do you eat for afternoon tea?
What time do you get home?
What do you do when you get home? Cook dinner, shop, do more work?
What do you eat for dinner?
What do you do between dinner and sleep?
What time do you go to bed?

Day 3

What time do you wake up?
What do you do between wake up and breakfast?
What do you eat for breakfast?
How long does it take you to get to work, take kids to school or get to other activities?
What time do you start work?
What do you eat for morning tea?
What do you do between morning tea and lunch?
What do you eat for lunch?
What do you do between lunch and afternoon tea?
What do you eat for afternoon tea?
What time do you get home?
What do you do when you get home? Cook dinner, shop, do more work?
What do you eat for dinner?
What do you do between dinner and sleep?
What time do you go to bed?

Day 4

What time do you wake up?
What do you do between wake up and breakfast?
What do you eat for breakfast?
How long does it take you to get to work, take kids to school or get to other activities?
What time do you start work?
What do you eat for morning tea?
What do you do between morning tea and lunch?
What do you eat for lunch?
What do you do between lunch and afternoon tea?
What do you eat for afternoon tea?
What time do you get home?
What do you do when you get home? Cook dinner, shop, do more work?
What do you eat for dinner?
What do you do between dinner and sleep?
What time do you go to bed?

Day 5

What time do you wake up?
What do you do between wake up and breakfast?
What do you eat for breakfast?
How long does it take you to get to work, take kids to school or get to other activities?
What time do you start work?
What do you eat for morning tea?
What do you do between morning tea and lunch?
What do you eat for lunch?
What do you do between lunch and afternoon tea?
What do you eat for afternoon tea?
What time do you get home?
What do you do when you get home? Cook dinner, shop, do more work?
What do you eat for dinner?
What do you do between dinner and sleep?
What time do you go to bed?

Day 6

What time do you wake up?
What do you do between wake up and breakfast?
What do you eat for breakfast?
How long does it take you to get to work, take kids to school or get to other activities?
What time do you start work?
What do you eat for morning tea?
What do you do between morning tea and lunch?
What do you eat for lunch?
What do you do between lunch and afternoon tea?
What do you eat for afternoon tea?
What time do you get home?
What do you do when you get home? Cook dinner, shop, do more work?
What do you eat for dinner?
What do you do between dinner and sleep?
What time do you go to bed?

Day 7

What time do you wake up?
What do you do between wake up and breakfast?
What do you eat for breakfast?
How long does it take you to get to work, take kids to school or get to other activities?
What time do you start work?
What do you eat for morning tea?
What do you do between morning tea and lunch?
What do you eat for lunch?
What do you do between lunch and afternoon tea?
What do you eat for afternoon tea?
What time do you get home?
What do you do when you get home? Cook dinner, shop, do more work?
What do you eat for dinner?
What do you do between dinner and sleep?
What time do you go to bed?

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