Detailed anamnesis

Before we
begin

So we can spend our time together on you rather than on paperwork, I'm collecting the essentials up front: you, your daily life and your goals.

Set aside 10 to 15 minutes. Most of it is tapping. You only need to write freely in three places.
Keep this page open until you submit. Your answers are deliberately not stored on your device. They only reach me with the final click.
Answer as things really are. There is nothing to dress up here — the more honest the picture, the more useful the plan.
Almost everything is marked * — this form is the basis for your strategy session, and I go through it beforehand. Wherever nothing applies, there is a matching answer to tick.
This page is completely tracker-free. No Google Analytics, no cookies, no tracking of any kind — the information you provide here is used solely for your individual coaching.

Personal details

* Required. If nothing applies, there is an option for that.

First name* Please enter your first name.

Last name* Please enter your last name.

Email address* Please enter a valid email address.

Date of birth* Please enter your date of birth.

Gender* Please choose an option.

What does your working life look like?* Please choose an option.

How much sport do you do?* Please choose an option.

Do you wear a sports watch or fitness tracker?*

Many models can be linked to the coaching app later on.

Which model?

Your goals

What would you like to achieve? multiple answers possible* Please choose at least one goal.

Would you like to describe your goal in more detail?

Household & living situation

Cooking for one is a different matter from cooking for a family.

How many people live in your household, including you?* Please choose an option.

Are there children in the household?*

If there is more than one of you: how often do you eat together?*

Is there anything about your living situation that affects how you eat? multiple answers*

Shift work Frequent travel Relatives to care for Two households Partner eats completely differently Small kitchen / little equipment No, nothing in particular Etwas anderes …

Please choose at least one answer — if nothing applies, there is an option for that.

Body measurements

The figures below are here to make your coming change visible — not to serve as dogma. Kilos and BMI give orientation, but they are not the holy grail.

Rather than chasing a rigid target weight, we aim for a healthy corridor: a body composition that feels good day to day and convinces in the mirror. That is precisely why we deliberately do not ask for a goal weight here.

Height (cm)* Please enter your height.

Current weight (kg)* Please enter your weight.

Waist at navel (cm)*

Measured at navel level.

Narrowest waist (cm)*

Narrowest point, above the navel.

Chest (cm)*

Biceps (cm)*

Thickest point, relaxed.

How do I measure correctly?

Waist at navel: Tape horizontally around the widest part of the belly, roughly at navel height. Breathe out gently; the tape rests without pulling.
Narrowest waist: The narrowest point between the lower ribs and the hip bone — usually just above the navel.
Chest: Tape horizontally around the ribcage at nipple height. For women, across the fullest part of the bust.
Biceps: Let the upper arm hang relaxed and measure at its thickest point — roughly midway between shoulder and elbow.

Take all measurements unclothed or in light underwear — and always at the same spot later on, so the numbers stay comparable.

I do not have a tape measure to hand — we will measure in our session

Eating & drinking

This is about your daily life as it really is — not about perfection.

How do you eat?* Please choose an option.

How many meals do you eat per day?* Please choose an option.

Do you eat breakfast?

Yes, regularly Sometimes No

What does snacking look like for you? multiple answers*

Something sweet in the afternoon Something salty in the evening Fruit between meals Nuts Bars / protein bars Cake or pastries at the office Barely any snacking No, I barely snack Etwas anderes …

When you snack is often more telling than what.

Please choose at least one answer — if nothing applies, there is an option for that.

How much caffeine do you have per day?*

Coffee, cola, energy drinks, black and green tea combined. Relevant to iron absorption, among other things.

Do you cook yourself or eat out often?* Please choose an option.

Lifestyle

How much do you sleep on average?* Please choose an option.

How would you describe your current stress level?* Please choose an option.

Your motivation

Why now?* A sentence or two is enough — but I do need this one.

What do you expect from working together? multiple answers*

Clear, practical recommendations Understanding how it all connects Structure and firm guidance Someone who follows up Flexibility without bans Expert reading of my numbers I am still open on that Etwas anderes …

Please choose at least one answer — if nothing applies, there is an option for that.

Medical information

Every medical detail asked for here is entirely optional.

Anything you would rather say in conversation, simply leave blank.

Do you take medication regularly? multiple answers

No, none Blood pressure medication Thyroid hormones (e.g. levothyroxine) Metformin or other diabetes medication Cholesterol-lowering medication Acid reducers Antidepressants Hormonal contraception Etwas anderes …

If you would rather mention this in conversation, leave it blank.

Everyday life in detail

A few things that shape eating more than people expect.

How do you sleep? multiple answers*

Good — I sleep through I struggle to fall asleep I often wake during the night I wake early and cannot get back to sleep My sleep is restless It varies No, I sleep well Etwas anderes …

Please choose at least one answer — if nothing applies, there is an option for that.

Do you smoke?

No Occasionally Regularly

Do you drink alcohol?

Not at all Occasionally Regularly

How much do you move in daily life, outside of sport? multiple answers*

Mostly sedentary Short walks A daily walk Bike instead of car A standing or walking job Stairs instead of the lift Much more active at weekends Not sure exactly Etwas anderes …

Please choose at least one answer — if nothing applies, there is an option for that.

What happens to your eating under stress? multiple answers*

I eat more sweet things I eat irregularly I forget to eat I reach for ready meals I drink more alcohol I eat late in the evening Stress does not change my eating No, it does not change Etwas anderes …

Please choose at least one answer — if nothing applies, there is an option for that.

Your story

What you have tried so far — and how it turned out. Bullet points are plenty, no essays needed.

How do you picture your life in a year, in terms of food and wellbeing?*

Consent

Almost there — just this one box.

Without your consent I am not permitted to process this information.

Before webegin

Personal details

Your goals

Household & living situation

Body measurements

Eating & drinking

Lifestyle

Your motivation

Medical information

Everyday life in detail

Your story

Consent

Thank you,that's everything

Before we
begin

Thank you,
that's everything