Bella's Wellness Survey
My goal is to help you feel your best self by wholistic health and wellness practices!
Name
*
First Name
Last Name
Email
*
example@example.com
IG handle
eg. "itsclairemckay"
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What are your top 3 health and wellness goals right now (eg. weight management, increased energy, better nutrition, improved skin health, stress management)
*
Weight management
Increase energy
Overall better nutrition
Improved focus
Improved skin health
Stress management
Improved healthy habits
Reducing exposure to harmful chemicals
Other
Are you currently satisfied with your skin?
*
Yes
No
Could be better
What challenges are you facing in reaching these goals?
Are you experiencing any of these common skin issues? Check all that apply.
*
Bloating
Digestive issues
Low energy/fatigue
Anxiety
Brain fog
Trouble sleeping
None of the above
Other
On a scale of 1-10 how satisfied are you with your energy levels throughout the day? (1 is not satisfied, 10 is very satisfied)
*
Are you familiar with ingredients in wellness and beauty products and how these things can affect your overall health?
*
I’m familiar but don’t really care
I’m somewhat familiar but could use some more info
I’m an avid label reader and all about that low-tox life
I’m not familiar with how ingredients affect my overall health
Which products or solutions are you most curious about? (check all that apply)
*
Gut Health
Protein
Skincare
Workout
Hair Care
30 Day Full Body Reset
Sleep aids
Cosmetics
Other
Are you experiencing any of these common skin issues? check all that apply
*
Acne
Oily
Dry
Signs of aging (fine lines/wrinkles)
Age spots/sun spots
Dull skin/lacking glow
Other
What areas of your life would you want to improve? check all that apply
*
Overall wellness
More community/friendships
More income/financial stability
Mindset/Mental health
Would you be interested in a personalized product recommendation based on your responses?
*
Yes, I'd love some suggestions
No thank you
Is there anything else you'd like to share about your wellness journey or how I can best support you?
Do you have 2-6 friends who would love to better their health, improve their skin, increase their energy or sleep better?
*
Yup I sure do
No friends
On a scale of 1-10, how interested are you in learning becoming a Brand Partner with Arbonne? (1 = Not interested at all, 10 = Very interested)
*
Are you open to hopping on a quick 15 minute consultation call to discuss your survey?
*
Yes!
Not right now
Submit
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