CUSTOM PERFORMANCE NUTRITION PLAN PHONE CONSULTATIONS

SIGN-UP Form

Welcome athlete!

Once you have submitted your inquiry we will contact you via email to schedule your phone consultation with one of our coaches.  High Performance Dietitian Rebecca Dent will answer any dietary questions you may have and will make every effort to ensure you are getting the most out of your nutrition and your training.

After your call she will send you a link for payment. Fees are as follows:

  • 30min – $60
  • 45min – $90
  • 60min – $120
  • 75min – $150
  • 90min – $180
  • 105min – $210
  • 120min – $240
  •  

Thank you for being a part of our Uphill Athlete community.

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Name*
Preferred Pronouns

Date of Birth*

ABOUT YOU

YOUR TRAINING GOALS

Please specify your training goals.

How important is it to you to achieve your goals?
How confident are you that you will make and maintain the advised changes?

YOUR CURRENT DIET

Write down roughly what an average daily intake looks like for you:

Note if you are very satisfied with the meal.
Note if you are very satisfied with the meal.
Note if you are very satisfied with the meal.
Note if you are very satisfied with the meal.
Note if you are very satisfied with the meal.
Note if you are very satisfied with the meal.

YOUR CURRENT TRAINING/LEVEL OF EXERCISE

AM/PM DAILY TRAINING

MONDAY
AM: Type
AM: Duration
AM: Speed/ Distance/ Volume
PM: Type
PM: Duration
PM: Speed/ Distance/ Volume
TUESDAY
AM: Type
AM: Duration
AM: Speed/ Distance/ Volume
PM: Type
PM: Duration
PM: Speed/ Distance/ Volume
WEDNESDAY
AM: Type
AM: Duration
AM: Speed/ Distance/ Volume
PM: Type
PM: Duration
PM: Speed/ Distance/ Volume
THURSDAY
AM: Type
AM: Duration
AM: Speed/ Distance/ Volume
PM: Type
PM: Duration
PM: Speed/ Distance/ Volume
FRIDAY
AM: Type
AM: Duration
AM: Speed/ Distance/ Volume
PM: Type
PM: Duration
PM: Speed/ Distance/ Volume
SATURDAY
AM: Type
AM: Duration
AM: Speed/ Distance/ Volume
PM: Type
PM: Duration
PM: Speed/ Distance/ Volume
SUNDAY
AM: Type
AM: Duration
AM: Speed/ Distance/ Volume
PM: Type
PM: Duration
PM: Speed/ Distance/ Volume

SUGGESTED DATES AND TIMES

Please provide three available days and times for you to take a call.
Date
Time
:
Date
Time
:
Date
Time
:
Consent*