Wellness Survey
Let's start by thinking about your wellness habits.
Personal Info
First Name
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Last Name
Email
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Phone
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Survey
Top Health Concern
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gut health
lack of energy
sleep
autoimmune disorder
skincare
weight loss
depression
anxiety
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Are you interested in easy healthy recipes?
Yes, I'd love some new ideas
Do you make time for daily gratitude check-ins?
I'd like to start
Yes!
Do you listen to podcasts related to health & wellbeing?
Yes!
I'd like to start
Would you exercise more at home if you had access to quick simple workouts?
Yes, I'd love some guidance
Is meditation part of your wellness routine?
Yes!
I'd like to start
Would you be interested in listening to solutions from wellness experts?
I'd be open to learning more
What do you struggle with when it comes to overall wellness? Check all that apply: Note: Did you know - Collagen formation helps maintain healthy bones, cartilage, teeth, and gums and supports healthy hair, skin and nails?
I have trouble eating enough fruits and vegetables daily.
I lack energy throughout the day.
I often experience bloating & poor digestion.
I drink too much coffee/tea/energy drinks.
I am not getting enough clean protein in my daily meals.
I am interested in assisting kidney & liver detoxification.
I'm looking for ways to boost my collagen production.
Which results are you looking for from your daily skincare routine: Check all that apply:
Increase Firmness
Reduce Fine Lines & Wrinkles
Improve Hydration & Glow
More Even Skin Tone (improve overall complexion & lessen sun damage)
Others
Check all that apply to you
I am mindful of using products with recyclable packaging.
I prioritize using non-toxic/clean products.
I support brands with clinical trials that show efficacy results.
Plant-based ingredients (either for health or environmental reasons) are important to me.
Are you interested in learning more about starting your own online wellness business?
I'd be open to learning more
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