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Personalised Health & Supplement Questionnaire

Answer these quick questions about your health, lifestyle, gut health, and diet to receive personalised supplement recommendations tailored to your needs. Your responses are completely confidential.

 

Gender
What are your primary health concerns or goals?
Symptoms (Check all that apply)
How many servings of fruits/vegetables do you eat daily
How often do you consume processed foods or sugary drinks
Do you follow a specific diet
How much water do you drink daily?
Do you consume alcohol or caffeine regularly?
Do you have any food intolerances or allergies?
Do you experience any digestive symptoms ?
What type of stool do you most frequently experience
How often do you have bowel movements
Do you experience discomfort during bowel movements
Have you ever been diagnosed with gut-related conditions? (e.g., IBS, Crohn’s, SIBO, etc.)
Are you experiencing any hormonal symptoms ? (Check all that apply):
What is the typical length of your menstrual cycle
How many days does your period last
How would you describe your period flow?
Do you experience spotting between periods?
Do you currently take hormonal contraceptives?
If you are in menopause or perimenopause: Are you experiencing symptoms like hot flashes, night sweats, or mood changes?
Are you trying to conceive or currently pregnant?
Are you currently taking any supplements?
Have you had any recent blood tests (within the past 6 months)?
How often do you exercise?
How would you rate your sleep quality?
What results are you hoping to achieve with supplements ?

Thank you

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