Health Quiz

Breakthrough Health Quiz

Name *

Email Address *

Occupation *

Age *

Phone *

1.) What health symptoms or reactions are you feeling or seeing due to your food choices, habits or business decisions? *

2.) What have you tried to heal your symptoms? (Doctors, Diets, Supplements, Detox) *

3.) What health goals do you want to accomplish? What about your business goals? *

4.) What’s been standing in your way? *

5.) What challenges are you struggling with right now in your health, work or business? *

6.) Are you working with a professional or therapist now? What condition or meds taken? *

7.) What are these symptoms costing you in time, money, energy or productivity in your life & business? *

8.) Without help, how do you see yourself getting from where you are now to where you want to be in your life, health or business? *

9.) Would you do whatever it takes to reach your health & business goals? How would you rate your motivation to do it? (Rating 1 lowest – 10 highest)

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Any Additional Information ?

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