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What’s your first name?
First Name
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Do you smoke?
Yes
No
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What is your eating habits?
Vegan diet
Vegetarian diet
My diet is generally healthy and includes animal protein, fish and veggies
My diet includes fast food and soft drinks
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How frequently do you consume alcoholic beverages?
≤ 3 times per week
4 - 7 times per week
7+ times per week
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How frequently do you have cold/flu symptoms?
≤ 2 per year
3 - 5 times per year
5+ times per week
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Describe your stress level
I feel calm and relaxed most of the time
I get nerevous from time to time
I’m under a lot of stress most of the time
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Have you ever been diagnosted with high blood glucose level?
Yes
No
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Tell us what you want to focus on
Weight managment
Stress relief
Immune boost
Need to solve a specific problem
I need a bassic kit for a daily intake
All in one
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What’s your email address?
Email
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