Diet & Lifestyle Diary

Diet & Lifestyle Diary

Complete this diet and lifestyle diary carefully and accurately. We need to know how you live your life and what you eat when you're not in the office with us. List in detail the quantity and the exact nature of all foods and beverages you consume (such as canned, frozen, fresh, raw, etc.).

Format: mm-dd-yyyy

Day One

Format: mm-dd-yyyy
Include time of day you had this meal.
Include time of day you had this snack.
Include time of day you had this meal.
Include time of day you had this snack.
Include time of day you had this meal.
Include time of day you had this snack.
Cups per day
Sugar, salt, spices, herbs, etc.
Type of activity and how long you did it.
What you did to relax and how long you did it.

Day Two

Format: mm-dd-yyyy
Include time of day you had this meal.
Include time of day you had this snack.
Include time of day you had this meal.
Include time of day you had this snack.
Include time of day you had this meal.
Include time of day you had this snack.
Cups per day
Sugar, salt, spices, herbs, etc.
Type of activity and how long you did it.
What you did to relax and how long you did it.

Day Three

Format: mm-dd-yyyy
Include time of day you had this meal.
Include time of day you had this snack.
Include time of day you had this meal.
Include time of day you had this snack.
Include time of day you had this meal.
Include time of day you had this snack.
Cups per day
Sugar, salt, spices, herbs, etc.
Type of activity and how long you did it.
What you did to relax and how long you did it.
Sending

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