Health & Lifestyle Questionnaire

Health & Lifestyle Questionnaire

Please fill in the questionnaire below
Do you feel that you receive balanced nutrition from the foods you eat?
How would you describe your energy levels?
Would you like to:
How much would you like to lose/gain?
Do you exercise?
Do you have any health concerns?

Other
I work with Herbalife International and help people with their nutrition. I personally have had great results myself: - I Used to: have belly fat, lacked energy during the day, struggled with drinking water Now: - I have dropped belly fat, gaining muscles in the right places. Way too much energy throughout the day - Weight train x5 days a week and cardio twice a week - Happy to annouce I am 10kgs lighter
A) For R2839 can I offer you ?
B) Can I call you with more information about the Challenge?
Name

First NameLast Name
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Phone Number

Area CodePhone Number
Whatsapp

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