Customized Supplement Recommendation

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Let's create a custom plan, just for you! Answer the questions below and I will send you a personalized recommendation.

FIRST NAME *

LAST NAME *

Select ALL of the symptoms you've experienced in the past 30 days: *

Constipation or irregular bowel movements

Diarrhea or loose bowel movements

Cravings for sweet or salty foods

Irregular appetite - no appetite or unable to feel full

Low muscle tone or inability to build strength

Inflammation or pain from achy joints, back, etc.

Headaches

Irregular or heavy periods

Painful cramps

Mood or energy changes leading up to or during period

Trouble falling or staying asleep

Getting 7+ hours of sleep, but waking up still tired

Food sensitivities (that aren't true anaphylactic food allergies)

Heartburn or indigestion

Low sex drive

Pain or discomfort during sex

Dry skin, brittle hair, hair loss,

Skin rashes or eczema

Acne

Anxiousness

Low mood or depressive energy

Trouble concentrating

Forgetfulness

Required

Which improvements would be MOST meaningful over the next 30 days? (Pick ONE area to start with) *

Improved Energy & Mental Clarity

Weight Loss & Improved Digestion

Less Anxiousness and Improved Mood

Hormone Balance, Improved Cycle & Sex Drive

I want it ALL!

Any medications or regular OTC drug use (NSAIDS, allergy, birth control, heartburn, antibiotics, etc)?

Which best describes your current nutrition? *

Mostly whole food meals prepared at home

Some whole food, some processed food meals prepared at home

Mostly processed food meals prepared at home

Some meals prepared at home, some meals eating out

Mostly eating out or convenience food

Find yourself mindlessly eating

Are you currently:

Perimenopause

Menopause

Post-Menopausal

On HRT

Clear selection

Which best describes the root of your stress:

High Stress / Demanding Career

Balancing Family and Career

Caregiving Parents and Children

Loss / Grief

Lack of Time for Yourself

Other

Anything else I need to know to support you in recommending the right products and plan to support your health goals and lifestyle?

Email to send results + recommendation to? *

I agree to be emailed by Dana Lewis *

Yes, send me my results!

What is you phone number (US-Based only)

What is your WhatsApp? (All other countries)

I agree to receive text messages (SMS or WhatsApp) from Dana. *

Yes

Required

Please select your country *

What is your flavor preference? (US Only)

Submit

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