Akanna Health Quiz

Health Quiz

Your health is your greatest asset, and understanding your risk factors is the first step to protecting it. This Health Risk Quiz is designed to help you identify how your age, family history, lifestyle, eating habits, medications, and symptoms may contribute to your chances of developing heart disease, stroke, or cancer. 💡 Why Take This Quiz? No lab work needed – simply answer a few questions about your daily habits and lifestyle. Fast and simple – takes less than 5 minutes to complete. Get personalized wellness insights within 24 hours. Discover natural, alternative options that may help lower your health risks. Your results can reveal how small steps today might lead to a longer, healthier life. Don’t wait for a health scare — take charge of your wellness now!
Name

First NameLast Name
E-mail
example@example.com
Phone Number

Area CodePhone Number
What is your Blood Type

ABABOUnknown
How Old Are You?

Under 3030-3940-4950-5960-6970-7980+
Gender

MaleFemaleOtherPrefer To Not Say
Has anyone in your immediate family (parents, siblings, grandparents) been diagnosed with any of the following? (Check all that apply)*
Heart Disease

YesNoNot Sure
Stroke

YesNoNot Sure
High Blood Pressure

YesNoNot Sure
High Cholesterol

YesNoNot Sure
Diabetes

YesNoNot Sure
Cancer

YesNoNot Sure
Do you have any of the above?
Have any close family members experienced a heart attack or stroke before age 50?*

YesNoNot Sure
How often do you engage in physical activity (at least 30 minutes of moderate exercise)?*

Up to 1 Hour DailyHardly Ever1-2 Times A Week3-4 Times A Week5+ Time A Week
How would you describe your stress levels?*

LowModerateHighExtreme
Do you smoke or use tobacco products?*

YesNoSometimesI Vape
How often do you consume alcohol?*

Never1-2 Time A Month1-3 Time A WeekDaily
How often do you eat fast food or processed meals?*

DailyAlmost Daily1-3 Time A Week3-4 Times A WeekRarely or Never
How many servings of vegetables and fruits do you eat per day?*

DailyAlmost Daily1-3 Time A Week3-4 Times A WeekRarely or Never
Do you consume fried or processed meats regularly? e.g.,Bacon, Hot Dogs, Lunch Meat, Sausage, Fried Chicken etc.*

YesNoOccaionally
How much water do you drink daily?*

Less Than 2 Cups Daily3-5 Cups Daily6-8 Cups Daily9+ Cups Daily
Are you currently on prescription medications for any of the following? (Check all that apply) *

High Blood PressureHigh CholestrolDiabetes Or Blood Sugar ManagementBlood ThinnersAnxiety Or DepressionWeight Loss InjectablesNone
Have you ever been diagnosed with pre-diabetes or metabolic syndrome?*

YesNo
Have you ever been diagnosed with pre-diabetes or metabolic syndrome?*

YesNo
Do you frequently experience any of the following symptoms? (Check all that apply)*
Frequent Headaches or Migraines

YesNoNot Sure
Shortness Of Breath

YesNoNot Sure
Chronic Fatigue or Low Energy

YesNoNot Sure
Chest Pains Or Tighness

YesNoNot Sure
Dizziness or Lightheadness

YesNoNot Sure
Numbness or Tingling In Legs/Arms/Toes

YesNoNot Sure
Unexplained Weight Gain/Loss

YesNoNot Sure
Frequent Bloating or Digestive Issues

YesNoNot Sure
Frequent Loose Stools/IBS

YesNoNot Sure
Constipation

YesNoNot Sure
Poor Sleep or Insomnia

YesNoNot Sure
Arthritis or Chronic Pain

YesNoNot Sure
None Of the Above

None Of The Above
Have you ever experienced a mini-stroke (TIA), irregular heartbeat, or sudden vision loss?*

YesNo
On a scale of 1-5, how willing are you to change your diet and lifestyle to prevent serious health issues?*

1- Not At All2- Slightly Willing3-Neutral4-Willing5-Very Willing
Essential Fatty Acids (Omega 3) - Check all that apply.*
I DO take a daily Omega 3 supplement

Yes
I DO NOT take a daily Omega 3 supplement

No
I DO eat a diet rich in Omega 3 foods like walnuts and salmon.

Yes
I DO NOT eat a diet rich in Omega 3 foods like walnuts and salmon.

Yes
Do you want to change you eating habits for better health results?

Yes
Is there anything additional you want to share?
⚠️ Your results will be reviewed by a certified a HIPAA Certified Wellness Coach & Corporate Scanners. Your sensitive data will not be shared and is secured. We suggest you review results with your Primary Health Care provider.

Your Health and Wellness Coach is WandaEllis Fant Distributor ID 171949.

Please allow her 48 hour to reach out to you. We are so happy to be part of your new life journey!
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