Customized Vitamin Test

Answer the following questions about yourself:

1.
Do you exercise on a daily or weekly routine?
Yes
No
2.
Do you smoke?
Yes
No
3.
Do you consume alcohol frequently or on a daily basis?
Yes
No
4.
Do you experience sleep problems?
Yes
No
5.
Are your often tired and stressed?
Yes
No
6.
Do you consume sufficient fruits and vegetables servings every day?
Yes
No
7.
Do you consume dairy products like milk, yogurt, and cheese regularly every week?
Yes
No
8.
Do you consume 2 to 5 servings of meat every week?
Yes
No
9.
Does it take your body a long time to overcome any flu or cold infections?
Yes
No
10.
Are currently suffering from digestive tract diseases that afflict the gallbladder, liver, pancreas, or intestine?
Yes
No
Please answer all of the questions before continuing.

Please provide us with your contact information to email your test results.

First Name:
Last Name:
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