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Vitamin Patch Club Questionnaire
1
Name
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First Name
Last Name
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2
Gender
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Male
Female
Prefer not to say
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3
Age
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Be honest
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4
Email
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We do not use this email to spam ever, and we don't share email addresses.
example@example.com
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5
Terms and Conditions
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Your Information will never be shared
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6
Why are you thinking about your vitamin needs?
*
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Please select below
I am an Athlete and want to up my game
I want to boost my immunity
I am just curious
I am scheduled for or just had surgery
I want to improve my general health
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7
Do you have health concern/s?
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Yes
No
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8
What are your top three health concerns
*
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None
Weight
Stress
Mood
Energy
Fitness
Immunity
Menopause
Aches and Pains
Inflammation
Hair, Skin, and Nails
Heart Health
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9
Are you on a special meal plan?
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please select what best describes your plan
None
Plant Based
Vegan
Paleo
Keto
Pescatarian
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10
Are you currently participating in regular exercise?
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Yes
No
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11
If you answered yes to regular exercise, please select which best applies to your exercise routine?
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Strength and Conditioning
Swimming
Yoga/Pilates
Running
Walking
MMA Training
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12
If yes to both exercise questions, Are you sore after your workouts?
*
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A good sore
Sometimes
OMG I can't walk or lift my arms
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13
Mood and Stress Level
*
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Super Chill
Stressed all the time
Lack of motivation
Lack of focus
Manageable Stress
Relatively happy but feeling discouraged
Recent life events have me spiraling downward
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14
Energy Levels
*
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Use your last seven days and average it out
Need a little boost
Always tired
I tend to crash in the afternoons
No complaints
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15
Joint and Bone Health?
*
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Tendonitis
Osteoporosis
Osteoarthritis
Rheumatoid Arthritis
None of the above
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16
How do you Sleep
*
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Like a baby
My mind races
Intermittently
I toss and turn
I have a snorer beside me
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17
Do you have weight loss goals?
*
This field is required.
Nope
3-10 Lbs
10+ Lbs
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18
Do you get adequate exposure to the sun?
*
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Adequate would be 20-45 minutes daily without sunblock or covered up
Yes
No
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19
Are you concerned about your Hair, Skin and Nails?
*
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Yes
No
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20
Do you experience?
*
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Select all which apply to you
Adrenal Issues
Chronic Pain
Chronic Fatigue
Mood Swings
Loneliness
Lack of Drive
None of the above
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21
Do you smoke tobacco?
*
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Daily
Yes
No
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22
Do you drink alcohol?
*
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Yes
No
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23
Do you eat Red Meat?
*
This field is required.
2-3 times a week
Yes
No
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24
Do you eat Fish?
*
This field is required.
2-3 times a week
Yes
No
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25
Beauty Patch (Biotin, Vitamin B7)
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26
Energize Patch (Vitamin B12 Patch)
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27
Restore Patch (Zinc)
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28
Strength Patch (Iron)
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29
Wellness Patch (Vitamin D3 + C)
*
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30
The Super8 B Complex
*
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31
Defense Bundle
*
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32
Support Bundle
*
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33
Total Package Bundle
*
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34
Stamina Bundle
*
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35
Duplicate-Beauty Patch (Biotin, Vitamin B7)
*
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36
Duplicate-Energize Patch (Vitamin B12 Patch)
*
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37
Duplicate-Restore Patch (Zinc)
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38
Duplicate-Strength Patch (Iron)
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39
Duplicate-Wellness Patch (Vitamin D3 + C)
*
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40
Duplicate-The Super8 B Complex
*
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41
Duplicate-Defense Bundle
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42
Duplicate-Support Bundle
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43
Duplicate-Total Package Bundle
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44
Duplicate-Stamina Bundle
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45
Top 1
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46
Top 1st Product
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47
Top 2
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48
Top 2nd Product
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49
Top 3
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50
Top 3rd Product
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51
Top 4
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52
Top 4rd Product
*
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53
Answer
*
This field is required.
Beauty Patch (Biotin, Vitamin B7)
Energize Patch (Vitamin B12 Patch)
Restore Patch (Zinc)
Strength Patch (Iron)
Wellness Patch (Vitamin D3 + C)
The Super8 B Complex
Defense Bundle
Support Bundle
Total Package Bundle
Stamina Bundle
Why are you thinking about your vitamin needs?
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What are your top three health concerns
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Are you currently participating in regular exercise?
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If you answered yes to regular exercise, please select which best applies to your exercise routine?
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If yes to both exercise questions, Are you sore after your workouts?
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Mood and Stress Level
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Energy Levels
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Joint and Bone Health?
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How do you Sleep
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Do you get adequate exposure to the sun?
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Row 9, Column 9
Are you concerned about your Hair, Skin and Nails?
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Do you experience?
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Do you eat Red Meat?
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Do you eat Fish?
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Total
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Why are you thinking about your vitamin needs?
What are your top three health concerns
Are you currently participating in regular exercise?
If you answered yes to regular exercise, please select which best applies to your exercise routine?
If yes to both exercise questions, Are you sore after your workouts?
Mood and Stress Level
Energy Levels
Joint and Bone Health?
How do you Sleep
Do you get adequate exposure to the sun?
Are you concerned about your Hair, Skin and Nails?
Do you experience?
Do you eat Red Meat?
Do you eat Fish?
Total
Beauty Patch (Biotin, Vitamin B7)
Row 0, Column 0
Energize Patch (Vitamin B12 Patch)
Row 0, Column 1
Restore Patch (Zinc)
Row 0, Column 2
Strength Patch (Iron)
Row 0, Column 3
Wellness Patch (Vitamin D3 + C)
Row 0, Column 4
The Super8 B Complex
Row 0, Column 5
Defense Bundle
Row 0, Column 6
Support Bundle
Row 0, Column 7
Total Package Bundle
Row 0, Column 8
Stamina Bundle
Row 0, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 1, Column 0
Energize Patch (Vitamin B12 Patch)
Row 1, Column 1
Restore Patch (Zinc)
Row 1, Column 2
Strength Patch (Iron)
Row 1, Column 3
Wellness Patch (Vitamin D3 + C)
Row 1, Column 4
The Super8 B Complex
Row 1, Column 5
Defense Bundle
Row 1, Column 6
Support Bundle
Row 1, Column 7
Total Package Bundle
Row 1, Column 8
Stamina Bundle
Row 1, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 2, Column 0
Energize Patch (Vitamin B12 Patch)
Row 2, Column 1
Restore Patch (Zinc)
Row 2, Column 2
Strength Patch (Iron)
Row 2, Column 3
Wellness Patch (Vitamin D3 + C)
Row 2, Column 4
The Super8 B Complex
Row 2, Column 5
Defense Bundle
Row 2, Column 6
Support Bundle
Row 2, Column 7
Total Package Bundle
Row 2, Column 8
Stamina Bundle
Row 2, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 3, Column 0
Energize Patch (Vitamin B12 Patch)
Row 3, Column 1
Restore Patch (Zinc)
Row 3, Column 2
Strength Patch (Iron)
Row 3, Column 3
Wellness Patch (Vitamin D3 + C)
Row 3, Column 4
The Super8 B Complex
Row 3, Column 5
Defense Bundle
Row 3, Column 6
Support Bundle
Row 3, Column 7
Total Package Bundle
Row 3, Column 8
Stamina Bundle
Row 3, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 4, Column 0
Energize Patch (Vitamin B12 Patch)
Row 4, Column 1
Restore Patch (Zinc)
Row 4, Column 2
Strength Patch (Iron)
Row 4, Column 3
Wellness Patch (Vitamin D3 + C)
Row 4, Column 4
The Super8 B Complex
Row 4, Column 5
Defense Bundle
Row 4, Column 6
Support Bundle
Row 4, Column 7
Total Package Bundle
Row 4, Column 8
Stamina Bundle
Row 4, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 5, Column 0
Energize Patch (Vitamin B12 Patch)
Row 5, Column 1
Restore Patch (Zinc)
Row 5, Column 2
Strength Patch (Iron)
Row 5, Column 3
Wellness Patch (Vitamin D3 + C)
Row 5, Column 4
The Super8 B Complex
Row 5, Column 5
Defense Bundle
Row 5, Column 6
Support Bundle
Row 5, Column 7
Total Package Bundle
Row 5, Column 8
Stamina Bundle
Row 5, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 6, Column 0
Energize Patch (Vitamin B12 Patch)
Row 6, Column 1
Restore Patch (Zinc)
Row 6, Column 2
Strength Patch (Iron)
Row 6, Column 3
Wellness Patch (Vitamin D3 + C)
Row 6, Column 4
The Super8 B Complex
Row 6, Column 5
Defense Bundle
Row 6, Column 6
Support Bundle
Row 6, Column 7
Total Package Bundle
Row 6, Column 8
Stamina Bundle
Row 6, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 7, Column 0
Energize Patch (Vitamin B12 Patch)
Row 7, Column 1
Restore Patch (Zinc)
Row 7, Column 2
Strength Patch (Iron)
Row 7, Column 3
Wellness Patch (Vitamin D3 + C)
Row 7, Column 4
The Super8 B Complex
Row 7, Column 5
Defense Bundle
Row 7, Column 6
Support Bundle
Row 7, Column 7
Total Package Bundle
Row 7, Column 8
Stamina Bundle
Row 7, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 8, Column 0
Energize Patch (Vitamin B12 Patch)
Row 8, Column 1
Restore Patch (Zinc)
Row 8, Column 2
Strength Patch (Iron)
Row 8, Column 3
Wellness Patch (Vitamin D3 + C)
Row 8, Column 4
The Super8 B Complex
Row 8, Column 5
Defense Bundle
Row 8, Column 6
Support Bundle
Row 8, Column 7
Total Package Bundle
Row 8, Column 8
Stamina Bundle
Row 8, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 9, Column 0
Energize Patch (Vitamin B12 Patch)
Row 9, Column 1
Restore Patch (Zinc)
Row 9, Column 2
Strength Patch (Iron)
Row 9, Column 3
Wellness Patch (Vitamin D3 + C)
Row 9, Column 4
The Super8 B Complex
Row 9, Column 5
Defense Bundle
Row 9, Column 6
Support Bundle
Row 9, Column 7
Total Package Bundle
Row 9, Column 8
Stamina Bundle
Row 9, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 10, Column 0
Energize Patch (Vitamin B12 Patch)
Row 10, Column 1
Restore Patch (Zinc)
Row 10, Column 2
Strength Patch (Iron)
Row 10, Column 3
Wellness Patch (Vitamin D3 + C)
Row 10, Column 4
The Super8 B Complex
Row 10, Column 5
Defense Bundle
Row 10, Column 6
Support Bundle
Row 10, Column 7
Total Package Bundle
Row 10, Column 8
Stamina Bundle
Row 10, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 11, Column 0
Energize Patch (Vitamin B12 Patch)
Row 11, Column 1
Restore Patch (Zinc)
Row 11, Column 2
Strength Patch (Iron)
Row 11, Column 3
Wellness Patch (Vitamin D3 + C)
Row 11, Column 4
The Super8 B Complex
Row 11, Column 5
Defense Bundle
Row 11, Column 6
Support Bundle
Row 11, Column 7
Total Package Bundle
Row 11, Column 8
Stamina Bundle
Row 11, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 12, Column 0
Energize Patch (Vitamin B12 Patch)
Row 12, Column 1
Restore Patch (Zinc)
Row 12, Column 2
Strength Patch (Iron)
Row 12, Column 3
Wellness Patch (Vitamin D3 + C)
Row 12, Column 4
The Super8 B Complex
Row 12, Column 5
Defense Bundle
Row 12, Column 6
Support Bundle
Row 12, Column 7
Total Package Bundle
Row 12, Column 8
Stamina Bundle
Row 12, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 13, Column 0
Energize Patch (Vitamin B12 Patch)
Row 13, Column 1
Restore Patch (Zinc)
Row 13, Column 2
Strength Patch (Iron)
Row 13, Column 3
Wellness Patch (Vitamin D3 + C)
Row 13, Column 4
The Super8 B Complex
Row 13, Column 5
Defense Bundle
Row 13, Column 6
Support Bundle
Row 13, Column 7
Total Package Bundle
Row 13, Column 8
Stamina Bundle
Row 13, Column 9
Beauty Patch (Biotin, Vitamin B7)
Row 14, Column 0
Energize Patch (Vitamin B12 Patch)
Row 14, Column 1
Restore Patch (Zinc)
Row 14, Column 2
Strength Patch (Iron)
Row 14, Column 3
Wellness Patch (Vitamin D3 + C)
Row 14, Column 4
The Super8 B Complex
Row 14, Column 5
Defense Bundle
Row 14, Column 6
Support Bundle
Row 14, Column 7
Total Package Bundle
Row 14, Column 8
Stamina Bundle
Row 14, Column 9
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1 Top 1st
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2 Top 1st
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3 Top 1st
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57
1st:
{top1st}
Benefits:
{1Top}
{2Top}
{3Top}
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1 Top 2nd
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3 Top 2nd
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2nd:
{top2nd}
Benefits:
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{2Top150}
{3Top151}
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1 Top 3rd
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2 Top 3rd
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3 Top 3rd
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65
3rd:
{top3rd}
Benefits:
{1Top155}
{2Top156}
{3Top157}
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1 Top 4th
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3 Top 4th
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69
Thanks
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