Chlorestrol Levels (LDL)
Blood Pressure Level
Blood Sugar Level
My Body Fat Level
My Fitness Goals
(Select 2 or more options)
Learn to eat balanced diet
Decrease Body Fat
Learn to balance activity & diet
Improve Overall Health
Improve Athletic Performance
Create a Healthy Lifestyle
Increase Strength & Power
Maintain a Healthy Weight
Other pls specify
Do You Smoke / Drink?
How has your skin/Hair/Teeth condition been in last few weeks?
Are you recovering from any recent health issues/taking any medications? (past 8 months?
Do you have any of the following health issues? (Heart/Blood Pressure/Diabetes/Bone-Joint disease/Low Immunity/Weakness-Dizziness/Obesity etc)
Have your parents suffered from any of the following health issues? (Heart/Blood Pressure/Diabetes/Bone-Joint disease/Low Immunity/Weakness-Dizziness/Obesity etc)]
Have you had gas/bloating/cough/cold/acidity/flu issues in last few weeks?
How frequently have you had food cravings in the recent past? (eg., for sugar or fast food, or calories dense food)
Do you have your meals at the same time every day? (+/- 30mins)
How many hours a week do you engage in vigorous physical activity? (Vigorous activity: Running,swimming, weight training, intensive sport like badminton, tennis, etc)
Rate your energy levels through the day?(On a scale 1-5; 1 being low and 5 is Highly energetic)
How much water do you drink daily?
Do you feel thirsty at any point of the day?
Recently how many hours have you slept in the night?
Do you get quality sleep?
Rate your memory/Clarity of thoughts/concentration levels based on your behaviour in last week
How is your sex life recently?
Do you feel dejected/sad/annoyed/irritated/lack of confidence?
Are you stressed or worried about the following? (1. Your appearance / Health issues 2. Your relationship / family member issues 3. Your work or community or home issues 4. Your financial responsibilities 5. About any bad occurrence lately)