Hello, Welcome to your Health Survey We get it you want to put the best in to get the best out. But finding the right supplement can be a minefield. So, let us do the hard work and tailor the right supplements for you. Take our quick and easy survey to cut the jargon and get the best supplements for the best you. Name Email 1. Basics How old are you? 16-30 31-45 45+ None 2. Basics What gender were you born with? Male Female Prefer not to say None 3. Basics (If female) Are you pregnant/a new mum/breastfeeding? Yes No None 4. Basics (If female) Are you actively trying for a baby? Yes No None 5. Basics (If female) Are you struggling to get pregnant? Yes No None 6. Basics (If female) Are you experiencing perimenopause? Yes No None 7. Basics Do you take vitamins? Yes No Sometimes None 8. Basics How would you describe your diet? Vegetarian No restrictions – if its food, I eat it Vegan Pescetarian None 9. Basics Do you have any allergies/sensitivities? Gluten Nuts Dairy Eggs Soy Lactose Seafood No Intolerances 10. Basics What is your priority health goal? Please select your answer Diet Immunity Brain Health Gut Health Stress & Anxiety Energy Skin & Beauty Muscles Joint Health Detox Sleep 11. Diet How many portions of fruit and veg do you eat each day? None 1-3 4-5 6+ None 12. Diet How often do you eat meat, fish or dairy? Never Once or Twice a Week Every Day None 13. Diet How often do you eat beans, nuts, seeds, or tofu? Never Once or twice a Week Every Day None 14. Diet Do you have any metabolic issues? Yes No Not sure None 15. Digestion After eating, what do you suffer most with? Bloating Gas Discomfort Heartburn None of the above None 16. Digestion What do you experience on a regular basis: Nausea Constipation Acid Reflux Diarrhoea None of the above None 17. Immunity How often do you get colds or the flu throughout the year? Never Once or twice Regularly None of the above None 18. Immunity How quickly do you recover from a cold or flu? 2-3 days 4-6 days Over a week None 19. Immunity Do you get frequent infections? Yes No None 20. Immunity Do you feel your body heals and regenerates quickly? Yes No None 21. Sleep How many hours sleep do you get each night? Less than 6 7-8 More than 8 None 22. Sleep Recently, how is your sleep health? Struggle to fall asleep Disturbed sleep Sleep soundly None 23. Sleep How do you feel when you wake up in the morning? Exhausted Refreshed Ok None 24. Sleep What do you experience at night: Leg twitches A racing mind Night Sweats None of the above None 25. Energy Would you describe your energy levels as low? Yes No None 26. Energy Do you feel tired and fatigued daily? Yes No None 27. Energy Would you like to increase your stamina? Yes No None 28. Brain Health Do you feel mentally fatigued? Yes No None 29. Brain Health Recently, have you experienced brain fog? Daily Occasionally Never None 30. Brain Health Do you feel like your brain isn't operating at its highest potential? Yes No None 31. Stress & Anxiety Do you feel happy? All the time Most days There is room for improvement Never None 32. Stress & Anxiety Which are you currently experiencing: Low mood Anxiety/worry Stress None None 33. Stress & Anxiety Do you battle: Depression Mental Health Issues None None 34. Stress & Anxiety Do you experience mood swings? Yes No None 35. Stress & Anxiety Do you suffer from addiction? Yes No None 36. Stress & Anxiety Recently, have you experienced headaches: Daily Occasionally Never None 37. Stress & Anxiety Do you feel a mental or physical overload? yes No None 38. Detox Do you want a deep detox of body, mind & soul? Yes No None 39. Detox Recently, have you experienced weight related issues? Yes No None 40. Skin & Beauty Which are you interested in tackling: Dry skin Breakouts Fine lines & wrinkles Premature aging None of these None 41. Skin & Beauty Is your hair experiencing: Dry scalp Hair Loss Slow growth Dull hair None of these None 42. Skin & Beauty Do you suffer from gum or teeth issues? Yes Sometimes No None 43. Skin & Beauty Are your nails: Dry & brittle Slow growing None of these None 44. Joints Have you broken any bones recently? Yes No None 45. Joints Do you experience: Joint pain Joint stiffness Joint swelling None None 46. Muscles How often do you exercise? Never 1-2 times a week 3-4 times a week Daily None 47. Muscles Do you experience muscle pain? Yes Occasionally Never None 48. Muscles Do you ache post workout? Yes No None 49. Muscles Do you experience muscle cramps or spasms? Yes Sometimes Never None Thank For your answers, We will compile a treatment plan for you based on your answers Time’s up
