1
Agreement
2
Questionnaire
3
Results
This questionnaire is to be used to educate on supplements that may support your body in it's natural healing process. This questionnaire and the Solle Naturals product statements found in these educational materials have not been evaluated by the Food and Drug Administration. These statements are not intended to diagnose, treat, cure, or prevent any disease or symptoms.
Question 1
I have a hard time staying asleep once I fall asleep.
Question 2
It is important to me to use a moisturizing cream on my face.
Question 3
I gain/carry weight in my midsection.
Question 4
I have heart burn.
Question 5
I have a low libido.
Question 6
I have less than 2 bowel movements a day.
Question 7
I have general aches and pains.
Question 8
I find it difficult to consume enough healthy oils and omegas in my diet.
Question 9
I feel so stressed or anxious that it hinders my life.
Question 10
I suffer from bloating or cramping during my menstrual cycle.
Question 11
I feel run down at the end of the day.
Question 12
I suffer from allergies.
Question 13
I have hormonal issues.
Question 14
I am agitated easily.
Question 15
I have a difficult time remembering things.
Question 16
I gain/carry weight in my midsection.
Question 17
I mentally and/or physically crash in the afternoon.
Question 18
I have digestive/intestinal issues.
Question 19
I am often sick due to the flu or cold.
Question 20
I am sensitive to gluten.
Question 21
I have diarrhea.
Question 22
I have dry skin.
Question 23
I need a stimulant to get going in the morning.
Question 24
I enjoy aromatherapy.
Question 25
I am concerned about my weight.
Question 26
I have respiratory issues.
Question 27
I have a hard time turning off my mind so I can sleep.
Question 28
My cholesterol is outside the normal range.
Question 29
My joints are often sore or achy.
Question 30
I suffer from headaches.
Please complete all questions to continue
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