HEALTH & WELLNESS QUIZ

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Share your goals with me and I'll help you achieve them! Fill out this form below and together we'll come up with a routine for you to get a jump start on your health and wellness journey.

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Do you suffer from any of these toxicity symptoms?

fatigue

digestion issues

mood swings

headaches

food cravings

pms

sleep issues

sinus problems

brain fog

difficulty losing weight

bad breath

low energy

skin issues

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What are your top health goals right now?

weight management

increased energy

improved quality of sleep

clearer skin

less bloating

more confidence

all of the above

Отменить выбор

What struggles do you have with nutrition?

food choices / what to eat / grocery shopping

eating on the go / busy lifestyle

not eating enough

eating too much

snacking / overeating

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What are you main skin concerns?

acne / blemishes

hormonal acne

fine lines / wrinkles

dullness

hyperpigmentation / uneven tone

dryness

oiliness

redness / irritation

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What's your current skincare routine?

What supplements are you currently taking? (ex: multivitamin, collagen, etc)

Do you have any food intolerances / allergies? Please list.

What's your first and last name?

What's your Instagram handle?

What's a good phone number for me to text you?

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