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1

First, tell us your name.

First Name

Last Name

2

Share your email with us.* This field is required.

example@example.com

3

What are your main health and wellness goals?* This field is required.(Select all that apply)

Weight loss

Improved energy levels

Muscle gain

Stress reduction

Better sleep quality

Improved mental clarity

Enhancing athletic performance

Other

4

What are the most important factors to you when selecting health and wellness products?* This field is required.(Select all that apply)

Price

Convenience: Easy-to-use products

Ingredients & quality of goods

Brand Reputation: Established and reputable brands

Effectiveness: Products with proven results

Specific Health Goals: Products targeted towards my specific health needs

Certifications: Products with third-party certifications (e.g., organic, non-GMO, etc.)

5

Are you interested in receiving personalized recommendations based on your health needs?

YESNO

6

What areas of health are the most exciting for you to learn about?* This field is required.(Select your TOP 3)

7

What is your preferred time commitment for health programs/consultations?

Short-term (e.g., 4-8 weeks)

Long-term (e.g., 1 year or more)

Medium-term (e.g., 3-6 months)

8

Last question. How ready are you to incorporate holistic natural remedies or herbal supplements into your lifestyle?1 being not ready 5 being I actively impelement holistic methods into my daily life.