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Health survey

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

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1

Your whole name?

How can I address you :)?
2

Instaaccount?

My Insta is @scorpion1997_cosplay
3

What is your current job?

It's important to know because of your daily routine :)
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4

What is your current well-being?

How do you feel? How much energy do you have right now?
5

How many liters of water do you drink daily?

Exclusively water, no other drinks.
6

How many times a week do you do sports?

Any kind of sport (gym, soccer etc.)
7

Do you consume caffeine to increase your performance/energy?

Select one or more answers
8

Do you suffer from headaches or even migraines?

Select one answer
9

Do you suffer from concentration problems?

Select one answer
10

Do you suffer from joint pain or/and tension?

Select one answer
11

Do you have skin problems/blemishes?

Select one answer
12

Suffering from hair loss?

Select one answer
13

Do you have problems with your scalp? Psoriasis or eczema?

Select one answer
14

Do you suffer from intestinal and digestive problems?

Select one answer
15

Do you often feel tired or exhausted?

Select one answer
16

Are you currently taking supplements for a vitamin deficiency?

Select one answer
17

How many times a year do you get sick?

Select one answer
18

Do you have any intolerances, intolerances or allergies?

Select one answer
19

How would you rate your diet right now?

Select one answer
20

How happy are you with your body/weight right now?

21

What is your health and well-being worth to you per month?

Select one answer
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