Health Checker Form

Health Checker Form
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STEP 1: Basic Details
STEP 2: Lifestyle Check
How active are you during a typical week?
How many hours do you sleep on average?
How often do you feel stressed?
How much water do you drink daily?
STEP 3: Gut Health Assessment
How often do you experience bloating?
How often do you experience constipation?
Do you feel heavy or uncomfortable after meals?
How often do you consume processed or junk food?
Do you experience acidity or indigestion?
STEP 4: Energy & Recovery Check
How would you rate your energy levels?
Do you experience afternoon energy crashes?
How often do you wake up feeling refreshed?
Do you feel tired despite getting enough sleep?
STEP 5: Nutrition Check
How many servings of fruits and vegetables do you consume daily?
Do you consume omega-3-rich foods (fish, walnuts, flaxseeds)?
Do you skip meals?
How often do you consume sugary foods or drinks?
STEP 6: Immune Wellness Check
How often do you fall sick?
How would you rate your immunity?
Do you experience frequent fatigue?
STEP 7: Joint & Mobility Check
Do you experience joint discomfort or stiffness?
Do you exercise regularly?
Do you experience muscle soreness that lasts longer than expected?

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Your Wellness Report
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