Free Nutrition Quiz – Health etc

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Free Nutrition Quiz

Free Nutrition Quiz

Personalized Nutrition Assessment Form

Fill this form and enjoy a free consultation with our in-house nutritionist.

Personal Details

Full Name: Age: Gender: Female Male Prefer not to say Email: Mobile Number (WhatsApp): Location (City, State):

What are the challenges you're currently facing?

Hair fall / thinning Insomnia or poor-quality sleep Frequent colds / low immunity Menopause-related symptoms (Females 40+ only) Stress or fatigue Brittle nails / dull skin Other:

Hair Fall / Thinning Questions

1. How long have you been noticing hair fall or thinning? Less than 3 months 3–6 months Over 6 months 2. Do you experience: Hair breakage Hair thinning at crown/temples Post-partum or hormonal hair fall 3. Any of the following apply to you? High stress levels Irregular periods Recent illness or recovery None of the above

Sleep Issues

1. What’s your biggest sleep challenge? Trouble falling asleep Waking up during night Waking up tired Irregular schedule / shift work 2. Frequency: Every night Few times/week Occasionally 3. Taking any calming supplements? Yes No

Immunity

1. How often do you fall sick? Once a month or more Every 2–3 months Rarely 2. What bothers you most? Frequent colds/sore throat Allergies/sinus issues Low energy / fatigue 3. Exposure to pollution/stress? Yes No

Menopause (Females 40+ only)

1. Are you in: Perimenopause Post-menopause Not sure 2. Symptoms: Hot flashes Mood swings Vaginal dryness Weight gain Poor sleep Brain fog None

Health & Lifestyle Assessment

1. Do you follow a specific diet? No specific diet Vegetarian Vegan Gluten-free Dairy-free Intermittent fasting Keto / Low Carb High Protein Other: 2. Currently on a diet plan? Yes No If yes, share intake (optional): Carbs (g): Protein (g): Fats (g): Total Calories (kcal): 3. Stress level: Low Moderate High Very high 4. Sleep duration: Less than 5 hours 5–7 hours More than 7 hours 5. Water intake: < 1 Litre 1–2 Litres > 2 Litres 6. Physical activity level: Sedentary Light Active Intense 7. Medications? 8. Supplements? 9. Allergies? 10. What matters in a supplement? Herbal Sugar-free Doctor-formulated Scientifically backed Fast results Safe long-term Gluten/dairy-free 11. Used health gummies before? Yes No 12. When to start? Immediately 1–2 weeks Just exploring

Free Nutritionist Consultation

13. Want expert consultation? Yes No 14. Preferred contact: WhatsApp Phone Email

Our nutritionist will review your inputs and respond within 24–48 hours with expert advice and personalized gummy recommendations, if needed.

Health etc

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Didn’t find your answer here? Just send us a message and we’ll help in no time.

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