Tell us about your health, routine & goals

This questionnaire helps Diet Shaala understand your lifestyle, food habits, medical history, and preferences so we can guide you better.

Approx. 5–7 minutes
Your details stay confidential
Personalized diet guidance

Thank you!

Your health questionnaire has been submitted successfully. Our team will review your details and connect with you soon.

Back to Home
Step 1 of 7

Personal Details

Saved locally
1

Personal Details

Basic information to help us identify and contact you.

Please enter your first name.
Please enter your last name.
Please enter a valid email address.
Please enter your phone / WhatsApp number. Country code, + sign and spaces are allowed.
Please enter your age.
Please select gender.
2

How You Found Us

This helps us understand where you discovered Diet Shaala.

Please select one option.
Please select at least one option.
3

Medical History

Share important health details so guidance can be planned safely.

Please select at least one option.
4

Eating Habits

Help us understand your normal food pattern and routine.

Please select food preference.
5

Meal Preferences

Tell us what is practical and sustainable for you.

6

Lifestyle

Your sleep, stress, activity, and digestion matter as much as food.

Please select activity level.
7

Goals & Commitment

Set a clear goal so we can support you in the right direction.

Please select at least one goal.
Please select at least one hurdle.
Please select one option.
Please select one option.
1 = Not ready 10 = Fully committed
Please select your commitment rating.
Please accept this consent to submit.

Your information is kept confidential and used only for health guidance by Diet Shaala.