Health Bio

* APEX HERBS - HEALTH BIO *

~ CLIENT FORM ~
HEALTH BIO:

Welcome to Apex Herbs, where nature's healing power meets holistic wellness 🌿💚
If you are interested in free herbs, scheduling, or just a free newsletter subscription with Apex Herbs, then you may find this Health Bio helpful. Please fill out all of the details below as accurately as possible so we can get started on your healing journey today!

it's time to stop living in pain and get your body back! Are you sick and tired of taking medications that is just a band-aid for your real issues? Are you ready to find out why your body is hurting? Apex Health Bio can answer all of these questions & more!

Answer the questions as detailed and as honestly as you possibly can below. A Representative will be scheduled with you shortly.

We look forward to joining you on your journey!
Client Survey Information

*More information about Apex Herbs is included below!
Name:*

First NameLast Name
Email:*
example@example.com
Social Media Name:
@abc123_
Phone Number:

Area CodePhone Number
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Age:
Gender:

FemaleMale
Civil Status:
How would you describe your overall well-being currently?
Do you have any existing medical conditions or chronic health issues?
[ If Yes, Describe ]
Do you have any known food allergies or sensitivities?
[ If YES, Details ]
Are there any dietary restrictions we should know about?
[ If YES, Describe ]
Do you have High/Low Blood Pressure?
Do you currently have Covid or Covid Symptoms [long lasting effects]?
Do You have Respiratory Problems [breathing problems]?
Do you have low. energy/fatigue?
Are you over weight?
Are you experiencing any digestive issues or discomfort[gut problems]?
Have you been hospitalized due to injury?
[ If YES, Details ]
Have you undergone surgery in the past year?
[ If YES, Details ]
Are you pregnant or expecting?
Are you currently taking any prescribed medication or supplemets?
How would you rate your stress levels on a scale from 1-10
Do You Have Pain In Your Body Today?

YesNoOther
How long have you been in pain?
Days, Weeks, Months, Years...
Describe the pain?

Review of System:

	Excellent	Good	Somewhat	Poor
Immune System (Spleen, Bone Marrow, Lymph Nodes, Tonsil, Thymus, Skin, ETC.)
Sensory (Touch, Hearing, Sight, Smell, Taste)
Musculoskeletal (Bones, Cartilage, Ligaments, Tendons, Connective Tissue)
Integumentary (Skin, Hair, Nails, Glands)
Neurovascular (Oxygenated Blood Vessels flowing to the Brain & Spine)
Circulatory (Heart, Arteries, Veins, Blood)
Respiratory (Organs & Tissues to Help Breathing)
Oral (Dental Health)
Psychosocial (Mental Health)
Nutrition (Food Intake)
Elimination (Liver, Kidneys, Lungs, Intestines, Skin)

Family Medical History:
How did you hear about Apex Herbs:
Apex Herbal Medicine

Purposes & Benefits
Here at Apex Herbs, we believe in giving people the ability to heal themselves while also improving the quality of their overall healthand body. To rejuvinate & revitalize their health, giving them a chance to be healthier without taking or being on medications.

We provide the clients with 100% Natural Raw Organic Herbs, in a 30-Day Supply Immune Support Package. That is used for it's many health benefits to the health and body. (A list of benefits will be provided below.)

You can/should go follow our Social Media Pages as well for news, updates, additional information, & promotions we provide. You can also contact us for more questions/information you may have about Apex Herbs.

Benefits:
- Detoxing health & body from toxins in the body (including: Covid Symptoms)
- Boosts the immune system
- Boosts energy
- Stabilizes blood pressure (high/low)
- Helps with weight loss
- Curves apoetite
- Stabilizes metabolism
- Controls glucose levels in case of diabetes
- Used as a diaretic
- Reduces glandular swelling
- Anti-aging
- Anti-inflammatory
- Anti-bacterial
- Anti-biotic
- Anti-viral
- Anti-oxidant
- Anti-microbial
- Anti-cancerous
- Anti-diabetes
- Laxitive
- Strengthens bones (makes them healthier and stronger)
- Promotes hair skin & nails growth (makes them grow healthier and stronger)
- Clears up a wide variety of skin conditions (eczema, acne, psoriasis, protects skin cells from damage)
- & SO MUCH MORE...
GOT ANY QUESTIONS? {Want More Information?}
Appointment {OPTIONAL}
Should be Empty:

* APEX HERBS - HEALTH BIO *

HEALTH BIO:

Client Survey Information

Apex Herbal Medicine