Name *
Name
Foods selections: please eliminate and replace;
Top 5 Unhealthy Foods (please select 5 to eliminate)
Top 5 Healthy Food alternatives: (please select 5 corresponding healthy alternatives for your 5 eliminated foods)
Activity selection: 30 minutes physically active (please select 6-7 days of the week that you’ll keep active)
Selection *
Beverage selections: please eliminate and replace
Top 5 Unhealthy Beverages (please select 5 to eliminate)
Top 5 Healthy Beverage alternatives (please select 5 corresponding healthy alternatives for your 5 to eliminated beverages)