Wellness Questionnaire
Welcome to our Online Health Community. We would love to find out where you need our supporting guidance. Take our 2 min wellness questionnaire.
Name *
Last name *
Email *
WhatsApp no/Phone no *
Province *
What do you currently eat for breakfast? *
How many times a day do you eat? *
Do you snack during the day? How many times? *
How much water do you drink per day? *
Do you workout? How many times a week? *
What are your health/ wellness/ body goals? *
Which challenge are you interested in? Every challenge starts with a 5 day intro, teaching you how to live a balanced lifestyle. All challenges are run online. *
I want more info & would love to start on a 21 day trial *
Accountability is key. Please put the name of a friend /colleague or family member who can keep you accountable. The 21 day trial is suitable for all goals. *
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