Client Forms

New Client Forms

New clients should print and complete the the following forms:
1) Disclaimer
2) Client Assessment
3) Health Objectives.

These forms will be brought to your first appointment. Please be thorough and answer the questions completely as possible. (PDFs are to printed and filled out).

Disclaimer / Client Agreement (PDF)
General Information about Jerry Casados and Plant-Based Nutrition and Lifestyle.
Disclaimer Form.pdf

Client Assessment(PDF)
A detailed questionnaire asking about diet, past and present health status.
Client Assessment Form.pdf 

Assessment Form Online

Health Objectives (PDF)
A questionaire on client’s health objectives and goals.
Health Objectives.pdf

Diet Diary (PDF)
Form tracking your food intake.
Daily Food Diary 7 Day.pdf

Daily Food Diary 7 Day.xlsx (This is Excel 2010 format if you want to input data and send it to us via email.)

Daily Food Diary 7 Day.xls   (This is Excel 2003 format if you want to input data and send it to us via email.)

Please contact me or call 303-944-4172 if you have any questions or need any help.