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Match With Your New Thyroid Nutritionist
Complete this quick questionnaire to be matched with a thyroid nutritionist who can help you with your specific goals.
7
Questions
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1
Which best describes you?
*
This field is required.
My diet & lifestyle need a lot of work
I have some existing healthy habits
I already eat well and stay active
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2
How many meals a week do you cook?
*
This field is required.
0
1-3
4-7
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3
What does your average lunch look like?
*
This field is required.
Soup or salad
Sandwich or wrap
Snacking
Other
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4
Have you been diagnosed with Hashimoto's disease?
*
This field is required.
Yes
No
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5
How much do these symptoms impact your life?
*
This field is required.
Very little
Somewhat
A lot
Weight
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Energy
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Stress
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Brain Fog
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Anxiety
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Weight
Energy
Stress
Brain Fog
Anxiety
Very little
Row 0, Column 0
Somewhat
Row 0, Column 1
A lot
Row 0, Column 2
Very little
Row 1, Column 0
Somewhat
Row 1, Column 1
A lot
Row 1, Column 2
Very little
Row 2, Column 0
Somewhat
Row 2, Column 1
A lot
Row 2, Column 2
Very little
Row 3, Column 0
Somewhat
Row 3, Column 1
A lot
Row 3, Column 2
Very little
Row 4, Column 0
Somewhat
Row 4, Column 1
A lot
Row 4, Column 2
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6
What do you want to improve?
Meal planning
Control snacking
Weight management
Hypothyroid symptoms
Other
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7
Email
*
This field is required.
We will send you your personalized thyroid nutritionist match.
example@example.com
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8
Get Page URL
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