Welcome to your Health & Beauty questionnaire 🤍
This is for informational purposes and does not commit you in any way. It's free and confidential.

I only offer natural products, without coloring and without artificial flavors.

Try to be as specific as possible so that I can offer you an adapted and personalized program according to your needs. 😊
Faça login no Google para salvar o que você já preencheu. Saiba mais
Surname, Name *
Phone number *
E-mail adress *
Date of brith *
DD
/
MM
/
AAAA
What is your goal? *
Do you have any allergies?(Please note everything if you have any)
Do you have heart, thyroid or blood pressure problems?
Do you take any medications, supplements? Please mention which ones and why?
Are you pregnant? Are you breastfeeding?
Limpar seleção
Do you snack often?
Limpar seleção
Are you eating regularly or are you skipping meals?
Limpar seleção
What is your type of food
Limpar seleção
Do you have good digestion? A good transit?
Limpar seleção
Are you stressed?
Limpar seleção
What is the quality of your sleep?
Limpar seleção
Do you have waves of fatigue during the day?
Limpar seleção
Do you have circulatory problems?
Limpar seleção
Where is your motivation to achieve your goals?
Limpar seleção
Thank you in advance for your time and your answers. It will allow me to advise you as best as possible and help you achieve your goals. I'll get back to you quickly. Romy
Enviar
Limpar formulário
Nunca envie senhas pelo Formulários Google.
Este conteúdo não foi criado nem aprovado pelo Google. Denunciar abuso - Termos de Serviço - Política de Privacidade
Google Formulários