HYGIEIA WELLBEING QUIZ
Our Nutrition Coach will review your quiz and put together recommendations for you. Recommendations for vitamins, supplements, diet, and overall wellbeing will be emailed to you. (within 24 hours) Visit our website- HYGIEIAWELLBEING.COM- use the code WELCOME for 10% OFF everything in the store. Follow us on Instagram- Hygieiawell for latest sales and new products.
How did you hear of Hygieia Wellbeing?
Internet Search
From someone
Social Media Ad
Other
Valid email
First and Last Name
Age Range
18 - 35 years
35 years to 45 years
45 years - 60 years
60 years plus
Gender
Female
Male
Prefer not to say
Other
Would you like recommendations for any of these areas
General Wellbeing/ health
losing weight
increased energy level
gaining weight
increased strength
managing sugar levels
cardiovascular/ heart health
immune support
bone health
eye health
joint health
hair and skin
healthy aging
work out supplements
memory/ cognition
sleep better
better mood
libido
relaxation
focus
anxiety
Other
Do you have any dietary restrictions/ special diet?
none
vegan
vegetarian
specific carbohydrate diet (SCD)
low fodmap
keto
gluten free
kosher
Other
Do you have allergies?
none
seasonal
soy
cow's milk
nuts
gluten
shellfish
fish
wheat
Other
How active are you?
do not exercise at all
light exercise such as walking for 30 minutes 3 to 7 times a week
moderate exercise such as exercise class or physical activity a few times a week
intense exercise such as hiit, weights, aerobic activity 30 minutes 4 or more times a week
Other
How many cups of vegetables do you have a day?
0 cups
1 to 2 cups
2 to 3 cups
3 to more cups
How many cups of fruit do you have a day?
0 cups
1 to 2 cups
2 to 3 ups
3 to more cups
How active is your job?
sit most of the day
move between sitting and walking
pretty active, standing and rarely sitting, lifting, moving around most of the time
very active with heavy lifting and constant movement
How many meals do you eat a day?
1
2
3
4 to 5
5 or more
Do you snack between meals?
yes
no
How many hours of sleep do you get in a 24 hour period?
less than 5 hours
5 to 6 hours
7 to 8 hours
More than 8 hours
Are you currently taking any supplements or vitamins? If yes, please list them.
Do you understand this questionnaire is to give recommendations to improve your health and are appropriate for most healthy individuals. We do not give medical advice. Always check with your doctor before starting a new supplement, diet, or exercise regimen for safety. Answer Yes or No
*
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