30 Day Culinary RX-AME and Lifestyle Medicine Challenge Survey

Enroll in Culinary RX-AME (One-time enrollment fee of $49.99 paid online for Lifetime Access at
www.ame-church.rouxbe.com) (non-refundable)

I understand the purchase of Culinary RX-AME is optional and not required to participate in the 30-day challenge

Faith In Action/Prayer – Pray first about all important life decisions

Nutrition – Try Meatless Monday, make ¾ of my meals/plate Colorful and Plant-Based, and eat more fresh foods naturally low in sodium for 30 days.

I will use the Harvard Healthy Eating Plate as a guide https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/ or
American Diabetes Association Diabetes Plate Method - https://www.diabetes.org/healthy-living/recipes-nutrition/eating-wellDiabetes Plate Method -

Read Nutrition Facts labels and look for food with 20% or less of sodium

Manage Stress – List how you will manage stress? (i.e. daily schedule, calendar, prayer, team meetings, balance home & life, ask for help, make to time for rest, enjoy a healthy and safe hobby)

Daily Fitness – Choose an activity of your choice and participate for 60 minutes (walking, swimming, bowling, dancing, house cleaning, washing the car, yard work, or other) Five minutes or intervals of time adding up to 60 also count!
I will select fitness activities that match my physical ability.
I will stop any activity that creates pain or is not recommended by my medical provider or for me.

Healthy Relationships – Galatians 5:18 – 26 and a take a look at your relationships

Self-Care – List healthy choices you will make over the next 30 days

Rest/Sleep – Make time for rest and a minimum of 7 hours of sleep. (i.e. a 10 minute break from screens/phone/social media, 15 minute nap, schedule breaks during long meetings for staff )

Laughter/Joy – for 30 days find or doing something that makes you laugh and/or puts a smile on your face

No Smoking/No Menthol for 30 days - find a smoking cessation program www.centerforblackhealth.org

Limit Alcohol – if you drink, limit and no more than one alcohol beverage for 30 days

On day 32 I will email International Health Commission (healcommission@aol.com) and share my experience

I will notify my medical provider immediately or EMS if I experience any health challenges during any fitness activity or dietary changes I choose to make during the 30-day challenge. Please check this box.

I understand I can stop the 30-day challenge at any time for health or personal reasons or I just no longer want to participate. Please check this box.

I understand if I purchased the Culinary RX-AME enrollment, the cost is not-refundable if I choose to end the challenge at any time. Enrollment in Culinary RX-AME is not required to take the 30-day challenge
I will have lifetime access to Culinary RX-AME if I enroll and purchase for $49.99, even if I do not participate in the 30-day challenge. Please check this box.

30 Day Culinary RX-AME and Lifestyle Medicine Challenge

Lifestyle Medicine is Faith in Action

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* 1. For 30 Days I will - check below each challenge you will accept:

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* 2. Enter your contact information. Your name and contact information will not be shared. Only the Medical Director and Executive Director will see your contact information. The only information that will be shared is your state and country along with your experience.