Health and Lifestyle Survey
How would you describe your lifestyle?
*
Do you think you eat 100% of the daily nutrition you need for good health?
*
Yes
No
Do you eat three meals a day?
*
Yes
No
Do you experience a loss of energy during the day?
*
Yes
No
Do you think you need to lose weight?
*
Yes
No
Do you think you need to gain weight?
*
Yes
No
Do you want to just maintain your weight?
*
Yes
No
How much weight do you want to lose/gain?
Why do you want to lose/gain weight?
Have you tried diet programmes in the past?
*
Yes
No
If yes, which ones?
Are you interested in finding out more about nutrition for sport?
*
Yes
No
Which sports do you participate in and how often?
Are you interested in finding out more about energy products?
*
Yes
No
Are you interested in finding out more about skin care products?
*
Yes
No
If you would like a well-being check, please tell us your height and weight:
Please fill in your contact details (name, email, phone)
*
When is the best time to phone you?
Would you like more information sent to you by email?
Yes
No
|
Welcome
|
|
Forthcoming Events
|
|
About
|
|
Healthy Living
|
|
Healthy Ageing
|
|
Sports Nutrition
|
|
Energy
|
|
Special Offers
|
|
Wellness Assessment
|
|
Skin care
|
|Survey|
|
Success stories
|
|
Newsletters Archive
|
|
Business Opportunities
|
|
Online shop
|
|
Links
|
|
Contact
|
|
Home
|
|
Other
|