Active Diet Fix Form

BF Active Diet-Fix: Questionnaire

Below are the steps to signing-up to any BFunctional service.

  1. Complete: the BF Questionnaire below [all client data is kept strictly confidential]
  2. Payment: re-directed to Go Cardless [online Direct Debit specialist that manages the entire collection process on behalf of BFunctional]
  3. Set-up: a one-off or monthly DD payment [GC will confirm your sign-up via email]
  4. Re-directed: to the BFunctional website.
  5. Confirmation: will be in touch within 48 hours.

Thank you and we look forward to working with you.

PERSONAL DETAILS


LIFESTYLE


FITNESS

1
1 being "NOT GREAT" and 5 being "BEST SHAPE OF MY LIFE"

NUTRITION:

1
1 being "BAD" and 5 being "IMPECCABLE"

GOALS


MEDICAL


Please read the BFunctional 'Nutrition Program' Terms and Conditions.