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Product Finder Questionnaire

Age

Gender

Male Female

Question 1 of 15

How often do you walk or perform moderate exercise (at least 30 minutes a day)?

Every day

3-5 times a week

Less than 3 times a week

Not at all

Question 2 of 15

Do you have high blood pressure?

Yes

No

Question 3 of 15

Do you have high cholesterol?

Yes

No

Question 4 of 15

Do you consume more than one serving of alcohol per day?

Yes, I'm a heavy drinker

I drink mainly on the weekends

I drink occasionally

No, I don't drink at all

Question 5 of 15

Do you have liver problems or high liver enzymes? Check all that apply.

I have general liver problems

I have high liver enzymes

I have a fatty liver

None of the above

Question 6 of 15

Do you get 30 minutes of direct sunlight 5-7 times a week?

Yes

No

Question 7 of 15

Do you feel your life is often filled with emotional stress?

Yes, my stress makes me feel overwhelmed and tired

Yes, I feel stressed and agitated, unable to relax

No, I normally do not feel stressed

Question 8 of 15

On average, how do you describe your sleep?

I have a hard time falling asleep

I sleep well and feel rested

Question 9 of 15

Do you often have sinus congestion?

Yes

No

Question 10 of 15

Over the past year, have you had many colds or respiratory infections?

Yes

No

Question 11 of 15

Do you have any eye related issues? Check all that apply.

I have dry eyes

I have blurred vision

I have poor night vision

None of the above

Question 12 of 15

Do you often feel pain in your joints or have inflammation?

Yes

No

Question 13 of 15

Do you suffer from heartburn or other digestive issues?

Yes

No

Question 14 of 15

Do you have thyroid issues?

Yes

No

Question 15 of 15

Do you have hair, skin or nail issues?

Yes

No

Congratulations! You Have Completed the Evaluation

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