Beneficiary Information

Body Mass Index

Current Weight (lbs)

Target Weight (lbs)

Height (in)

Age

Sex Select Male Female

Metabolic Inputs

Resting metabolic rate (cal)

Surplus / Deficit Select 0 (Maintain) -250 cal -500 cal -750 cal -1000 cal +150 cal +250 cal

Lifestyle (activity level) Select Sedentary Lightly Active Moderately Active Very Active Super Active

Exercise (cal)

Macronutrient Breakdown

% of TEE for Protein

% of TEE for Fats

% of TEE Carbs

Total: 0% — must equal 100%

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