Health Questionnaire 
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1. What does a typical day of eating look like for you currently? What did you eat yesterday for example? *
How much water do you drink daily? *
Do you drink tea or coffee? If yes, how many cups per day? *
Do you lack energy? *
Do you have any health concerns? If yes, please specify *
How is your skin? *
How would you rate your wellness and immune system from 1-5? 5 being tip top! *
Any allergies or dietary requirements?  *
Do you currently exercise? If so, how many times a week and what exercise do you do? *
What are your overall goals?  *
Finally, how serious are you about improving your health/wellness and achieving your goals from 1-10? 1 being not at all, 10 being 100% committed.  *
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