THE HEALTH FAIRY
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Health Fairy Survey
Name
(Required)
First
Last
Date of birth
(Required)
MM slash DD slash YYYY
Email
(Required)
Gender
(Required)
Male
Female
Food preference
(Required)
Meat eater
Vegetarian
Vegan
Pescatarian
Other
What's your favourite meal?
(Required)
Are you thinking of losing weight?
(Required)
Do you like exercise?
(Required)
Are you healthy?
(Required)
Do you feel you need help?
(Required)
Do you work out?
(Required)
At home
At the gym
Other
Do you have injuries?
(Required)
Are you on medication?
(Required)
Could you see your future self healthy?
(Required)
Do you worry about aging?
(Required)
Are you always on social media?
(Required)
Do you constantly compare yourself to others?
(Required)
What is your dream home?
(Required)
Where do you see yourself in 10 years?
(Required)
Do you smoke?
(Required)
Do you drink?
(Required)
Are you looking for new habits?
(Required)
Do you want more knowledge on how to look and feel good?
(Required)
Are you a good listener?
(Required)
Do you fail tasks?
(Required)
Do you get excited when you do a challenge?
(Required)
Have you joined our free membership for women to feel and look good?
(Required)
Yes
No
Do you want to know more on fitness, health and beauty?
(Required)
Yes
No