Wellness Assessment: Discover Your Personalized Health Plan

Wellness Assessment: Discover Your Personalized Health Plan

Restoring clarity, mobility, vitality & beauty where others see limits.
Full Name

First NameLast Name
Contact Number
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Email Address
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Each question uses a 1-5 scale, where 1 represents "Needs significant improvement" and 5 represents "Excellent."
Clarity: "How would you rate your mental focus, memory, and ability to think clearly?"

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5

1 is Worst, 5 is Best
Mobility: "How would you rate your physical mobility and freedom from discomfort in joints and muscles?"

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2

3

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5

1 is Worst, 5 is Best
Vitality: "How would you rate your energy levels, immunity, and overall sense of wellness?"

1

2

3

4

5

1 is Worst, 5 is Best
Beauty"How would you rate your skin’s health, glow, and overall appearance?"

1

2

3

4

5

1 is Worst, 5 is Best
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Each question uses a 1-5 scale, where 1 represents "Needs significant improvement" and 5 represents "Excellent."