Which area below is your primary wellness focus? *
Joint health and mobility
Immune support
Energy and vitality
Hair, skin, and nails
Digestive health
Weight management
Mental clarity and focus
What’s your specific goal for joint health and mobility? *
Improve flexibility and reduce joint discomfort.
Support recovery after exercise or physical activity.
Maintain an active lifestyle and stay mobile.
Reduce stiffness associated with aging.
Which of the following activities do you find difficult because of your joints? *
Using the stairs
Taking a walk
Bending
Household chores
Other
Which of your joints gives you the most discomfort? *
Knees
Elbows
Shoulders
Ankles
Lower Back
What’s your specific goal for immune support? *
Strengthen my immune system year-round.
Deal with seasonal allergies.
Support recovery after illness or injury.
Promote a balanced and resilient immune response.
Which immune support vitamins do you already take?
Vitamin C
Vitamin D
Magnesium
Elderberry
Zinc
Quercetin
Where do you spend the majority of your day?
At home
In an office
Outdoors
Retail environment
What's your specific goal for energy and vitality? *
Increase sustainable energy throughout the day.
Reduce reliance on caffeine or stimulants.
Support energy for exercise and daily tasks.
Improve stamina and endurance.
When do you struggle the most with lower energy? *
First thing in the morning
Mid-morning
Lunch time
Mid-afternoon
Evening
What do you reach for when your energy is low? *
Coffee
Energy Drink (With Sugar)
Energy Drink (Sugar Free)
Tea
Physical Activity
I sneak away for a nap
Nothing - I just try to get through it
What's your specific goal for skin, hair, and nails? *
Achieve radiant, hydrated skin.
Improve hair strength, thickness, or texture.
Strengthen brittle or weak nails.
Reduce fine lines and support youthful skin appearance.
What's your biggest hair concern? *
It's too thin
Too much comes out on my brush
It's dull & lifeless
It breaks or splits too easily
What's your skin type? *
Dry
Oily
Dull
Sensitive
What's the biggest problem with your nails? *
They break or chip easily
They grow slowly
They have a dull color
What's your specific goal for digestive health? *
Improve regularity.
Improve gut comfort.
Reduce occasional bloating or gas.
Support a balanced gut microbiome.
Promote better nutrient absorption.
When does your gut bother you the most? *
Before I eat breakfast
After I eat any meal
After eating fruits or vegetables
Only after eating a big meal
Eating makes me feel... *
Like I have to rush to the bathroom
Like I'm going to have trouble going to the bathroom
Bloated and/or gassy
Like I'm still hungry
Slow or sluggish
What's your specific goal for weight management? *
Lose weight safely and sustainably.
Build muscle or improve body tone.
Maintain my current weight.
Support metabolism and energy balance.
What are your current eating habits? *
Generally good - I watch what I eat
The "see-food" diet - I see food, I eat it
I've tried multiple diets but nothing sticks
I eat too many carbs & sweets
How much do you exercise? *
I go for a walk once in a while
I try to exercise at least 3x per week
Does getting off the couch count?
I'm always in the gym or physically active
What's your specific goal for mental clarity and focus? *
Improve focus and productivity at work or home.
Enhance memory and cognitive sharpness.
Reduce occasional brain fog or sluggish thinking.
Support relaxation and mental balance during stress.
Support a more positive mood.
What's your favorite brain exercise? *
I do word puzzles
I'm an avid reader
I play strategy games
I engage in deep & stimulating conversation
When is your brain the most tired or unfocused? *
Midday
Early evening
Right before bed
Where or how do you prefer to purchase your products? *
Online
In a retail store
Over the phone
Which of these product formats do you prefer? *
Capsules
Powders
Gummies
Beverages
Name *
Age *
Gender
Region *
Dietary Restrictions
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