GFN Diet Center


The GFN Diet Center has a team of qualified experts, which helps the members of GFN achieve fitness, with a number of health care services.

GFN Diet Center Offers:

  • Diet Consultation.
  • Diet plans, tailored specifically for the individuals, depending on his/her health conditions & goals.
  • Follow up and tracking the diet of the members.
  • Weight Management Programs.
  • Weight Management Tips.

GFN diet center is glad to make a difference in the lives and promoting a healthier community by helping its members in every possible way.

For the free consultation and Diet plan please contact your Fitness Center or contact the Weight Management Center on or

Nutritional Assessment

Membership Information

GFN Membership Number/ ID Number


Birth Date

Medical History

Check the following medical conditions you have been diagnosed with:
Heart diseaseHigh blood pressureAsthma/Respiratory problemsGI disordersCancerHeart attackHigh cholesterolSleep apneaGall bladder diseaseCardiovascular diseaseHigh triglyceridesDiabetesRenal diseaseStrokeMetabolic syndromeThyroid conditionLiver diseaseNot suffering from anythingOther


List from newest to oldest

Type of Injury:

Date Injured:

Therapy? (E.g physio):

List all medications:

List all known allergies:

Additional Comments

Physical Status


Current Weight:

Highest body weight

At Age

Lowest body weight

At Age

Body composition:

If you have had your body fat and muscle mass estimated by devices such as skinfold calipers, the Bod Pod, or bioimpedance analysis please provide the information below.

Lean Body Mass:


Body Fat:


Date measured:

Lifestyle/ Sports Information

In which sports do you participate (list sports and how often you do each sport):

List activity in each day of the week below.

Current training period:




Vitamin and mineral supplements:

Weight loss, herbal or sports supplements:

Food allergies:

Food dislikes:

Describe your daily eating habits:

Alcohol Frequency:

Alcohol Quantity:

Alcohol Type:

What do you eat and drink (list specific foods/drinks and quantities):
2-3 hours before workout?:

1 hour before workout?:

During a workout?:

After a workout?:

How often do you eat at restaurants or consume take-out or fast food?

How often do you eat snack foods? Type?

Describe your typical eating environment (e.g. alone, with a spouse or roommate, in car, at desk):

What is your primary goal for your nutrition counselling experience overall?

What 3 nutrition changes do you think should you make starting today?



Preferred strategy for nutrition intervention:

Day-to-day meal planFood choices (e.g. 2 starches, 3 protein) + selectionsGeneral guidelines (e.g. eat 6 vegetable servings/day)General guidelines (e.g. eat 6 vegetable servings/day)

Other Comments:

term and condition

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