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* What is your gender?

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* Which statement best describes your main health goal?

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* Optional: If "other" please specify below. If not simply click the question underneath.

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* If you could speak with one survival-health expert, to ask whatever questions you want, which would it be?

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* Optional: If "other" please specify below. If not simply click the question underneath.

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* What is your biggest health concern now or for the future?

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* Optional: If "other" please specify in the box below. If not, simply click the question underneath.

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* Optional: Is there anything else I should have asked you?

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* Optional: What is your email address?

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* Thank you very much! On the condition we do NOT try to sell you anything, do you consent to being contacted via telephone in the future?

We will NEVER cold call you. All conversations will be arranged in advance via email.

That way, we may choose to ask you a few follow-up questions so that our next product better matches your needs.

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