The Wellness Audit
Hi there! Thanks so much for connecting 🤍 Helping us understand what wellness looks like for you - so we can create more resources that serve real people, not just algorithms…
Name
*
First Name
Last Name
Feel welcome to add your Instagram profile
Add your Facebook profile (for inclusion in our FREE Healthy living community)
Text Number
If you’d like me to follow up personally, drop your number here. Otherwise, skip ahead ✌🏼
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 the top 3 things you’d love to feel better about in your body or health?
*
Which of these show up for you from time to time?
*
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
None
Other
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)
Severe cramping
Heavy bleeding
Irregular cycles
PMS that affects daily life
If you have a weight/inflammation release goal, what would be your ideal number?
1-10lbs
10-20
20-30
30+
Let’s talk about the foundation — your gut! These answers help me know how much you already understand about the connection between gut, skin & mood...
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 (or another GLP1 drug)
Both
I would like to learn about 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
What areas of health/wellness are you most curious about, interested in, or wanting support around? (Check any that resonate 💛)
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 & healing
Skin care (anti aging, dryness, oily etc)
Sports nutrition & support
Nutrition/skin ideas for kids and teens
Intermittent fasting
General wellness / just learning for now
Other
How would you love to be supported or resourced right now?
*
Invite me to your healthy living community on FB
I’d love to get personalized recommendations based on my answers
I’m open to hearing about clean swaps & habit tips
Please tell me about more ways to save & earn free wellness products
Please send me info on how to earn some extra $ by simply sending out a survey 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.
I just want to support your research for now (no follow-up needed)
Would you be open to staying connected or sharing this with others if it feels aligned? (Totally optional 💛)
Yes! I know a few people who might love this convo
I’d be open to a small sample night / wellness hangout with friends
I’d rather just come to another event sometime
Coffee/chat with a friend sounds fun ☕️
Not right now, but check back with me later
I’m just here to learn for now
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
If you’d like to chat about your results or ideas for you, when’s a good time window?
Between 9am to 5pm
Between noon to 5pm
Between 5pm to 9pm
What time zone are you in?
*
Please Select
Alaska
Pacific
Mountain
Central
Eastern
Email please.
example@example.com
Please share your address so that we can mail you a thank you a gift!
Mailing Address
City
State
Zip
What would you say is the single most important thing you’re working on right now to take your life to the next level — or anything else you’d love for me to understand about your goals/vision or current season?
Thank you for helping us make a big healthy living impact through Arbonne!
🌟 Thank you for sharing your energy! 🤍Your answers give us a window into what you’re dreaming of & working toward - and that means so much. Whether you filled this out to support our project or because you’re personally ready for your own next level, we’re genuinely grateful you took this step. We’ll review every response prayerfully & thoughtfully. If you asked for personalized guidance, we’ll reach out soon with encouragement, ideas & resources that align with where you’re headed. Here’s to growth, freedom & living fully on purpose 🎁
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