Limitless Living Wellness Survey

Name

First NameLast Name

Email

example@example.com

IG Handle

example: @limitless.kate

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

On a scale of 1 to 5, how would you rate your overall wellness?

1 being poor - 5 being good

How often do you engage in 30 minutes of physical activity or exercise weekly?

On a scale of 1 to 5, how would you rate your stress level?

1 being not stressed at all - 5 being extremely stressed

Are you currently experiencing any of the following? Check all that apply.

Do you have any dietary restrictions or preferences?

Are you currently satisfied with your skin?

Are you experiencing any of these common skin issues? Check all that apply.

What supplements are you currently taking?

Are you familiar with ingredients in wellness & beauty products and how these things can affect your overall health?

How much per month are you allocating to wellness (gym, supplements, etc) and beauty products?

I want to help you thrive! What's the best way I can share resources with you to address some of these things that might be affecting your skin or your overall health? Check all that apply.

Can I add you to my "Limitless Living" VIP group on Facebook where I share free resources, podcasts, health hacks, tips & tricks, product links, discount codes, workouts, healthy recipes, and virtual & in-person connection opportunities for living your best life?

Are you open to hopping on a quick 15-minute consultation call to discuss your survey?

Do you have any questions or comments for me? I'd love to hear them!

Limitless Living ~ Wellness Survey