STEP ONE — YOUR PERSONALIZED BASELINE

Regulate & Glow Challenge Intake & 3-Day Food Log

Welcome in, love. This is where your journey begins. Take about 15–20 minutes to complete your intake so we can personalize your nutrition guidance and establish your baseline before the challenge starts.
Complete before your first check-in.
WELCOME

We're So Excited You're Here!

This intake helps us personalize your nutrition guidance and establish your baseline before we begin.

Please answer every question honestly. There are no "right" or "wrong" answers. The more accurate your responses are, the more personalized your experience will be.

At the end of this form, you'll complete a 3-Day Food Log, which we'll use to better understand your current eating habits.
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15–20 Minutes
Take your time — this is your baseline.
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No Judgment
Honesty over perfection, always.
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Fully Personalized
Your answers shape your protocol.
YOUR INTAKE FORM

Let's Personalize Your Experience

Complete every section as honestly as you can. Your answers directly shape your custom nutrition protocol, coaching support, and the tools we'll offer you throughout the challenge.
Required fields are marked. Take breaks if you need to — your progress will save as you go.
FOR PROGRESS PHOTOS: Set up camera in a well lit area, wearing as minimal clothing as comfortable (like a bikini). Stand tall and relaxed, take a photo from the front, both sides side and back view. Either set your camera on a timer, or take a video moving from front to side to back to side and standing still in each pose for a couple of seconds; then screenshot each still post to upload as photos.
WAIST MEASUREMENT: Use a soft (ideally self locking) measuring tape and measure directly over your belly button.
Progress photos and waist measurement are not required to participate but they are required in order to win the challenge.

Regulate & Glow Intake Form

Welcome to the Regulate & Glow Challenge! Completing this form is mandatory in order to receive your nutrition protocols. If this form is not completed before August 2, you will be given generalized guidelines with no customization.

We're so excited you're here!
This intake helps us personalize your nutrition guidance and establish your baseline before we begin.
Please answer every question honestly. There are no "right" or "wrong" answers.
The more accurate your responses are, the more personalized your experience will be.

At the end of this form, you'll complete a 3-Day Food Log, which we'll use to better understand your current eating habits.
What’s your biggest goal for this challenge?*
What are you struggling with most right now?*
How committed are you to showing up for yourself during this challenge?*
FRONT PROGRESS PHOTO
RIGHT SIDE PROGRESS PHOTO
LEFT SIDE PROGRESS PHOTO
BACK PROGRESS PHOTO
Waist Measurement: Measure directly over belly-button
Current weight
GOALS: Why did you join the Regulate & Glow Challenge?*
What would make this challenge feel like a huge success?*
Which best describes your PRIMARY goal?*
Rate your average ENERGY (1= low, 5=high)*
Rate your body CONFIDENCE (1=low, 5=high)*
How often do you poop?*
What are your average daily steps? (if you don't know say how active outside of exercise and how many walks you go on per day)*
How many hours of sleep do you get on average per night?*
How much water do you drink per day?*
Which digestive symptoms are you currently experiencing? *
Explain anything else about your digestion you would like us to know
Which of these do you regularly experience?*
How stressed do you currently feel?*
How would you currently describe your eating patterns?*
Which Nutrition approach would you prefer during this challenge?*
List any food allergies or sensitivities
List any current supplements and medications*
List any median conditions or mental health diagnosis you experience*
Are you pregnant or breastfeeding?
Is there anything else you would like us to know?
3 DAY FOOD LOG: List ALL FOODS you have consumed in the last 3 days. This includes drinks, snacks, licks and bites. The purpose of this food log is NOT to judge your eating. It is simply to help us understand your current habits so we can provide better nutrition guidance. Please be as honest and accurate as possible.*
Food log accuracy - this is to assess how accurate your food log is*
Questions before you begin? Reach out to us at coach@beyondtheweights.net — we're here for you.
3-DAY FOOD LOG

How to Complete Your Food Log

Please record 3 complete days of eating — two weekdays and one weekend day.

The purpose of this food log is NOT to judge your eating. It is simply to help us understand your current habits so we can provide better nutrition guidance.

Please be as honest and accurate as possible.
Include Absolutely Everything
  • ✓Meals & snacks
  • ✓Drinks & alcohol
  • ✓Condiments & creamers
  • ✓Bites, licks, and tastes
  • ✓Gum & mints
  • ✓Supplements
YOUR COMMITMENT

Progress Doesn't Require Perfection. It Requires Consistency.

By joining this challenge, you are committing to showing up for yourself over the next four weeks. The more honestly you participate, the more you'll get out of this experience.

We can't wait to walk this journey with you.
COMPLETE MY INTAKE & FOOD LOG
With love,
Joëlle & Alysa