NUTRITION ASSESSMENT QUESTIONNAIRE Welcome to Lose Fat Weight Loss Solutions. We look forward to supporting you in your journey to better health through weight loss.Just fill out the form and one of our online weight loss coach will get in touch with you. You will learn about our programs and we will answer all your questions. Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Phone *Are you currently on a special diet?YesNoIf yes, describe it.What is your height?What is your current weight?How much weight do you want to lose?Do you have a current exercise routine?YesNoAdditional Comments?When done click ''Submit''Submit Share with Your Friends and Follow for More.TweetEmailPocketShare on TumblrTelegramWhatsApp