Molly Mangan
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Meal Prep Intake Form
Help me create the perfect nutrition plan for your goals!
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Thank you for your response. ✨
First Name
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Last Name
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Email
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Phone number
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Date of Birth (YYYY-MM-DD)
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Gender
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Select one option
Male
Female
Other
Prefer not to say
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Height
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Weight
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What are your main goals with meal prepping?
(required)
Build consistent meal prep habits
Learn to eat balanced meals without tracking
Improve energy and reduce fatigue
Develop a healthier relationship with food
Stop emotional or stress eating
Eat out less and cook more at home
Build muscle and gain strength
Lose weight sustainably
Improve athletic performance
Manage a health condition through nutrition
Simply eat healthier overall
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How long would you like to take to complete this goal?
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Select one option
1 month (quick habits or short-term focus)
3 months (build sustainable habits)
6 months (significant lifestyle change)
12+ months (long-term transformation)
No specific timeline (focus on the process)
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What’s your biggest challenge right now?
(required)
Don't know what to eat
No time to cook
Don't enjoy cooking
Always eating out or ordering in
Inconsistent schedule
Lack of motivation
Emotional or stress eating
Food cravings
Not seeing results from current efforts
Confused by conflicting nutrition advice
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Do you have any food allergies or intolerances?
(required)
Yes
No
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Dietary Restrictions (select all that apply)
(required)
Vegetarian
Vegan
Gluten-Free
Dairy-Free
Keto
Paleo
Halal
Kosher
Low-Carb
None
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Any foods you dislike or won’t eat?
(required)
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Do you have any favorite foods or cuisines you eat regularly?
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Preferred Meals Per Day:
(required)
Select one option
2
3
4
5 – 6
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Time available for cooking:
(required)
Select one option
20 min or less
30 min
45 min
60+ min
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Weekly Food Budget
(required)
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Please list any medications or supplements you are taking:
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Any other information or questions for me?
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Molly Mangan 