Essential Data Collection Ahead of RMR & mBCA Testing

Please complete this form BEFORE your Metabolic Assessment. This information is essential for our AI-driven analysis, allowing us to triangulate your test results with your real-world experience. Completion time: 5 minutes.

SECTION 1: CLIENT DETAILS

Full Name *

Email *

Date of Your Metabolic Test (DD/MM/YYYY) *

SECTION 2: YOUR PRIMARY GOAL

What is your single biggest priority right now? *
fat_lossmuscle_massperformanceenergymetabolismother

SECTION 3: SUBJECTIVE METABOLIC SYMPTOMS

How would you describe your current progress? *
progressingstuckgaininglosing_unwell

How are your daily energy levels? *
stableafternoon_crashlow_flattired_wired

Please check any physical symptoms you regularly experience:
coldpuffydigestivelibidohungernone

If you experience bloating, when does it primarily occur?
no_bloatingmorningafter_eatingthroughout_day

SECTION 4: CURRENT FUELLING & HISTORY

How do you currently approach your nutrition? *
meticulousloosediet_no_trackintuitive

If you track, what is your average daily calorie target?

For approximately how long have you been eating at this (or a similar) low calorie level? *
Not in a calorie deficitLess than 3 months3 to 12 months1 to 3 yearsMore than 3 years

What are your 1-3 primary carbohydrate sources?
processedwholefruitsugaryvegetables

SECTION 5: ACTIVITY, STRESS & RECOVERY

How many dedicated training sessions do you complete per week? *
0 to 1 session2 to 3 sessions4 to 5 sessions6 or more sessions

What style of training do you primarily do? *
Strength / WeightliftingCrossFit HYROX FunctionalEndurance Running CyclingPilates Yoga Low IntensityTeam SportsMixed Training Styles

When do you typically train? *
fasted_morningfed_morningafternoonevening

Outside of the gym, how would you describe your day? *
sedentarylightly_activeactive

On average, how many hours of sleep do you get per night? *
Less than 5 hours5 to 6 hours7 to 8 hoursMore than 8 hours

Rate your average daily psychological stress from 1 (Low) to 10 (High) *
1 Very Low2345 Moderate678 High910 Very High

How recovered do you feel from your training sessions? *
recoveredsore_functionalbeaten_down

SECTION 6: HEALTH & MEDICATION

💊 CRITICAL FOR DIAGNOSIS:

Please be 100% accurate in this section. Medications for thyroid (T3/T4) or stimulants (ADHD) directly elevate your RMR. This information is essential to avoid a misdiagnosis.

Are you currently taking any of the following? (Check all that apply) *
nonethyroidtrthrtstimulant

Please list any other significant medications or supplements you take regularly:

SECTION 7: DATA CONSENT

We are collecting sensitive personal health data. This data will be used solely for our AI-driven analysis to create your personalised metabolic report and will be handled with strict confidentiality in accordance with UK GDPR.

Data Consent & Acknowledgements *
accuracyconsentguidancegp_consult