"*" indicates required fields Name* Email* INSTRUCTIONS Please write down all foods and beverages consumed for three 24-hour time periods. Each day starting at 12:00 am and ending at 11:59 pm. Choose three consecutive days, including two weekdays and one weekend. You will be asked to record all vitamin, mineral, and herbal supplements you took at the end of each record. List the approximate Time the meal was consumed List each Food/Beverage Item you consumed, including foods eaten between meals and all drinks, even if it is a non-caloric item like water, coffee, tea, or sugar-free gum Record the Amount of each food or beverage consumed. Portion sizes can be recorded in a variety of ways, please use the method that works best for you. Date of record* MM slash DD slash YYYY Meal tablePlease click + to add a new itemTimeFood/Beverage ItemAmount Add RemovePlease list all vitamin, mineral, and herbal supplements you took todayType of SupplementReason for Taking Add RemoveWould you consider your intake of foods and beverages today to be typical of most days or was it considerably more or less? Explain why if not typical?Please list all planned physical activity performed today.Activity TypeDuration (minutes or hours) Add RemovePlease check me Δ
