Healthy Active Lifestyle
1.Name
2.Occupation
3.Locality
4.Do You Take Breakfast Daily?
Yes
No
Some times
5.Do You Get Enough Protein Vitamins and Minerals Needed For Your Body Every Day (Balanced Diet)
Yes
No
Some times
Don't Know
6.Do You Take Nutrition Supplements l.E., Proteins/Vitamins/Minerals/Micronutrients?
Daily
Never
Sometimes
Don't Know
7.Do You Eat Fruits and Vegetables Daily?
Yes
No
8.Do You Have an Active Life Style or Sedentary Life Style?
Active
Sedentary
9.Do You Experience Lack of Energy During the Day or by Evening?
Yes
No
Occasionally
10.Do You Have a Coach to make you Stay Healthy?
Yes
No
Don't Know
11.Do Your Family members/ Friends Need to Lose /Gain Weight or Looking For Health Improvement or Nutrition Guidance? (Problems/Goals)
Lose Weight
Gain Weight
Health Improvement
Don't Know
12.Are you Interested to get Health Tips if yes Please Enter Your Whatsapp Mobile Number.
-
Area Code
Phone Number
Submit
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