Getting Started: Food

Complete all forms (background information, food, movement, and mind) at least 48-hours before your scheduled consultation. If you have any questions, please contact us at or (949) 287-3433.

Name *
How many meals do you typically eat in one day? *
Select the option that most closely reflects your food situation: *
Do you have any known food allergies? *
You may select more than one answer.
Do you include the following foods in your diet in a typical week?
Vegetables *
Carrots, broccoli, spinach, etc.
Fruits *
Apples, oranges, strawberries, etc.
Whole grains *
Brown rice, whole grain bread, etc.
Fast food *
Burgers, pizza, fries, etc.
Pre-made meals *
Frozen meals, convenience foods, etc.
Packaged snack items *
Chips, crackers, cookies, etc.
Lean protein *
Fish, chicken, tofu, etc.
Red meat *
Beef, pork, etc.
Caffeine *
Coffee, tea, soda, etc.