Phone
*
Email
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What is your current level of physical activity?
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Low
Medium
High
Have you ever had a comprehensive blood exam to check for potential health issues?
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Yes
No
Do you experience any symptoms related to hormone imbalances, such as fatigue, weight gain, or mood swings?
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Yes
No
Have you ever had a checkup specifically for gut health, such as a microbiome analysis or stool test?
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Yes
No
Do you experience any skin issues, such as acne, eczema, or psoriasis?
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Yes
No
Have you ever experienced any chronic pain or discomfort that hasn't been resolved through traditional medical treatments?
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Yes
No
How would you describe your current health and the way you feel daily?
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