VITA-scan | VITAFIT

First name

Family name

E-mail

Telephone

Age

Gender

How are you feeling in general right now?

I often have low energy

I have difficulty managing my weight

I snack a lot or get hungry quickly

I want to improve my muscle mass

My digestion/intestines are not functioning optimally

I often feel bloated

My hormones sometimes seem out of balance

I don't sleep optimally

I actually feel pretty okay, but I want to feel even better

What do you usually eat/drink in the morning?

I often skip breakfast

Coffee & a small snack (cookie, sandwich, croissant…)

A classic breakfast (bread with toppings, yoghurt with granola…)

A full breakfast (eggs with bread, oatmeal with fruit…)

I vary, no fixed routine

I use meal replacements or protein shakes

How active are you?

Not active

Light activity (walking, housework, etc.)

Moderately active (1–2x sport/week)

Active (3+ sports/week)

What does your water intake look like per day?

How motivated are you to achieve results?

small steps - big results