Vitamin Buddy Lifestyle Questionnaire

Take the Vitamin Buddy™ Lifestyle Questionniare to find the optimal supplement plan for you.


Are you male or female?


Male

Female

How old are you?


In general, how much stress do you have in life?

0

1

2

3

4

5

6

7

8

9

0 = None at all

9 = A lot, constantly

In general, how are your energy levels?

0

1

2

3

4

5

6

7

8

9

0 = Very Low

9 = Very High

Do you regularly struggle to fall asleep?

Yes

No

Do you regularly struggle to get up in the
morning?

Yes

No

How many hours do you exercise a week?

0

1-2

2-5

5 or more

How often do you get colds?

Rarely

More than 3 times a year

How often do you smoke cigarettes?

Never

Seldom

Less than 10 a day

More than 10 a day

Are you on any restrictive diets?

No

Vegetarian

Vegan

Pescetarian

Paleo

Gluten-Free

Dairy-Free

Other

How many portions of fruit and veg do you eat per week?

None

1-5

6-13

14+

How many servings of eggs, nuts & seeds, and soy products do you eat per week?

None

1-3

4-6

7+

How many units of alcohol do you drink in an average week?

1 shot of spirit is 1 unit, a medium glass of wine or pint of beer is approximately 2 units.

None

1-8

8 or more

How many caffeinated drinks do you consume each week?

0

1-3

4-6

7 or more

In an average week, how many soft drinks,
juices and sugary beverages do you consume?

None

1-3

4-6

7 or more

Is there anything you're particularly concerned
about or want to improve?

No

Immune System

Weight Loss

Bone Health

Stress Relief

Hair or Skin or Nails

Anti-ageing

Low Energy

Depression and Anxiety

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