1.What is your full name?

2.Do you eat breakfast - If any?

Nothing

Cereal

Porridge

Fruit

Toast

Cereal

Yoghurt

Coffee

Tea

Protein(eggs,fish, protein shake)

3.What is your current weight and height?

4.How much weight do you need to lose?

5.What diet have you tried before to lose weight- if any?

My own diet / eating less

Weight Watchers (WW)

Keto

Jenny Craig

Lite ‘n’ Easy

Paleo

Low-Carb

Low-Fat

Intermittent Fasting

Atkins

Other

6.Why do you want to lose weight?

Feeling Uncomfortable

Health Reasons

Special Occasion

Other

7.What is your usual Diet?

Asian

Asian-Vegetarian/Vegan

Indian/Srilankan

Indian/Srilankan - Vegetarian/Vegan

Mediterranean

Mediterranean- Vegetarian/ Vegan

Western

Western Vegetarian/Vegan

Gluten- Free

Other

8.Do you have any targeted health issues?

Allergies

Blood Pressure

Cholesterol

Digestive

Joint Pains

Arthritis

Diabetes

Thyroid

Over Weight

Under Weight

Lack of energy

Lack of sleep

Skin Conditions

Hair issues

Other

9.What is your email address? WhatsApp/Viber/Mobile (Cell) number? Best local time to contact you?
Who do you know may be like to receive information about our products list their (name, email address, WhatsApp/Viber number). Thanks for participating in our survey.

10.Which country do you currently live?