Arbonne Wellness Survey
We are so excited to be here with you!! Let’s create a wellness journey together!
Name
*
First Name
Last Name
Please add your Instagram profile so that we can connect with health tips
Add your Facebook profile (So I can add you to a private group with specials)
Text Number
*
We will send you suggestions here based on your answers 😃
Format: (000) 000-0000.
Who can we thank (friend, host, consultant etc.) for sharing this survey with you? (We like to send them a thank you gift)
*
First Name
Last Name
What are your top 3 health struggles or goals right now? (please describe)
Are you currently experiencing any of the following? (check all that apply!)
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Weight Gain
Hormone shifts
Irritability/Mood swings
Difficult periods/irregular periods
Bloating
Digestive Gut Issues
Anexiety/Depression
Low Energy/Fatigue
Brain Fog/Overwhelm
Trouble Sleeping/Sleep disruption
Hot Flashes/Night sweats
Joint Pain
All of the above (like I have!!)
None
Women's focus: Which life stage best describes you right now?
Just dealing with my regular cycle.
Trying to get pregnant.
Pregnant or Postpartum
Perimenopausal (irregular cycles and hormonal shifts)
Menopause (no period for 13months+,vaginal dryness, low libido, nights sweats/hot flashes, sleep issues, irritability)
Post-menopause (continuation of vaginal dryness, low libido, nights sweats/hot flashes, sleep issues, irritability)
NA
If you have a weight loss goal, what would be your ideal number?
1-10lbs
10-20
20-30
30+
Are you familiar with gut health and how this can affect your overall health, your skin, and your mental health?
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I'm familiar but could use more info
Yes! I'm a gut health enthusiast
No
Do you use HRT (Hormone Replacement Therapy) or Ozempic ? (select all that apply)
HRT
Ozempic
Both
I would like to learn about Arbonne’s GLP-1 Natural alternatives.
Are you experiencing any of these common skin issues? Check all that apply.
Acne
Oily skin
Dry skin
Signs of aging
Fine lines and wrinkles
Dark/Age spots
Dull skin/lacking glow
Other
Would you be interested in learning about our innovative NAD inside and out, newest product?
Yes!!’
Tell me more!
What other areas of your life/health are you most concerned about and interested in? (check all that apply)
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Reading labels
Shifting to cleaner ingredients
Immune system recalibration
A1C/Blood sugar balance
High blood pressure
IBS/Ulcerative Colitis/Crohns
High Cholesterol HDL/LDL
Digestive issues/Gut health
Injury recovery and healing.
Skin care (anti aging, dryness, oily etc)
Sports nutrition and support.
Nutrition/skin ideas for kids and teens
Intermittent fasting
Other
We want to help you grow in your healthy living journey! (Check all that apply)
I’d love an invitation to your FREE healthy living community on FB.
I’d love to get recommendations based on my answers.
I would love to get a 35% discount on my next purchase.
Please send me info on how to earn a little extra $ by simply sending out surveys to my connections.
I'd love to talk about the financial independence that building a business with Arbonne can create. I'm ready for more in my life.
Would you help us share Arbonne with your circle of health minded friends and family?
Yes! I have some friends that I can share this survey with.
Sure, how about 3-4 friends at my house to sample and chat?
Absolutely, but I'm busy, so a texting party with no video requirements is easy and I'd love to set one up!
I'm not up for a party at my house or a survey, but I would love to bring a couple of friends to your next event!
Let's do coffee with my bestie!
What areas of your life do you want to improve? (Check all that apply!)
Overall Wellness
More Community/Friendships
Extra Income/Financial Stability
Mindset/Mental health
Other
What time of the day in the next couple of days would work for a 15 minute follow-up chat.
*
Between 9am to noon.
Between noon and 5pm
Between 5pm to 9pm
What time zone are you in?
*
Please Select
Alaska
Pacific
Mountain
Central
Eastern
Please share your address so that we can mail you a thank you gift and samples!
Mailing Address
City
State
Zip
What else should we know about you?
Thank you for helping us make a big healthy living impact through Arbonne!
Submit
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