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Health & Performance Supplements - Client Questionnaire
This questionnaire should take you around 10-15 minutes to complete. It has been designed by our world-class nutrition team. The more information you provide, the better the plan we can make for you!
Section 1 of 7: Profile
Q1. First name
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Q2. Last name
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Q3. E-mail
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Q4. Age
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Q5. Gender
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Q5. Gender
A
Female
B
Male
C
Non-binary
D
Other
E
Prefer not to say
Q6. Height (cm)
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Q7. Weight (kg)
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Q8. Country of residence
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Q9. Occupation / job activity level
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Section 2 of 7: Goals
Q1. What are your main health and performance goals? (select all that apply)
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Q1. What are your main health and performance goals? (select all that apply)
Q2. Are you currently training for a specific athletic event(s)?
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Q3. If yes, which event(s) are you preparing for? (select all that apply)
Q3. If yes, which event(s) are you preparing for? (select all that apply)
Q4. What is your ideal supplement strategy? (choose one)
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Section 3 of 7: Current Supplement Use
Q1. Are you currently taking any supplements?
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Q2. Please list the supplements you currently take (add as much information as you can e.g.: name; dosage; frequency)
Q3. Which of your current supplements are working well for you?
Q4. Please list any supplements you do not tolerate well or wish to avoid
Q5. Do you have any preferences for supplement format?
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Q6. How many supplements would you be comfortable taking daily?
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Section 4 of 7: Lifestyle & Training
Q1. How many days per week do you exercise?
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Q2. What types of training do you currently do?
Q2. What types of training do you currently do?
Q3. On average, how long is each training session?
Q4. What % of your training session are 'hard' (all out)
Q5. What % of your training sessions are 'moderate' (challenging but can sustain)
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Q6. What % of your training sessions are 'easy' (can converse)
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Q7. How many hours do you typically sleep per night?
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Q8. How well do you sleep
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Q9. Do you do shift work?
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Q10. How would you rate your current stress levels or life demands?
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Section 5 of 7: Medical History & Symptoms
Block A: General & Family History
Q1. Do you have any diagnosed medical conditions?
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Q2. Have you had any major surgeries or hospitalisations?
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Q3. Do
you take any prescription or over-the-counter medications regularly?
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Q4. Tell us about any allergies or intolerances
Q5. Do you have any family history of health conditions? (select all that apply)
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Q5. Do you have any family history of health conditions? (select all that apply)
Q6. Do you smoke or vape?
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Q7. How many alcoholic drinks do you typically have per week? (1 drink = 175 ml wine, or 330 ml beer, or 25 ml spirits)
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Block B: Gut & Digestion
Q8. Do you regularly experience any digestive issues? (select all that apply)
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Q8. Do you regularly experience any digestive issues? (select all that apply)
Q9. Do you often have constipation or sluggish elimination?
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Q10. Do you have any of the following conditions? (select all that apply)
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Q10. Do you have any of the following conditions? (select all that apply)
Block C: Immunity & Inflammation
Q11. How often do you typically get colds, flu, or infections?
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Q12. Do you experience ongoing pain, inflammation, or injuries? (select all that apply)
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Q12. Do you experience ongoing pain, inflammation, or injuries? (select all that apply)
Q13. Do you have any concerns about your liver health? (e.g.: poor alcohol tolerance; past liver issues; toxin sensitivity)
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Block D: Cardiometabolic & Body Composition
Q14. Do you have any of the following? (select all that apply)
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Q14. Do you have any of the following? (select all that apply)
Q15. How would you describe your ability to recover from exercise?
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Block E: Energy, Hormones & Brain
Q16. Do you regularly experience any of the following? (select all that apply)
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Q16. Do you regularly experience any of the following? (select all that apply)
Q17. Female-specific questions. Are you experiencing any of the following (select all that apply)
Q17. Female-specific questions. Are you experiencing any of the following (select all that apply)
Q18. Male-specific questions. Are you experiencing any of the following (select all that apply)
Q18. Male-specific questions. Are you experiencing any of the following (select all that apply)
Q19. Do you have any diagnosed mental health conditions? (select all that apply)
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Q19. Do you have any diagnosed mental health conditions? (select all that apply)
Section 6 of 7: Nutrition & Habits
Q1. Which best describes your current eating pattern?
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Q2. On average, how much protein do you eat daily? (Use the palm of your hand to estimate: 1 palm of animal protein = 25g; 1 palm of plant protein/dairy = 10g)
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Q3. How often do you eat oily fish?
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Q4. Which types of fat do you mainly eat? (select all that apply)
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Q4. Which types of fat do you mainly eat? (select all that apply)
Q5. How many servings of vegetables do you usually eat per day? (1 fist = 1 serving)
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Q6. How many servings of fruit do you usually eat per day? (1 fist = 1 serving)
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Q7. What do you mainly drink each day? (select all that apply)
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Q7. What do you mainly drink each day? (select all that apply)
Q8. How many caffeinated drinks do you usually have per day? (includes tea, coffee, energy drinks, most fizzy sodas)
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Q9. Do you follow any fasting or meal timing pattern?
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Section 7: Final Wrap-up & Preferences
Q1. Is there anything else about your health, lifestyle, or goals that you’d like us to know?
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Q2. Would you be open to optional lab testing in future (bloodwork, DNA, microbiome)?
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Q3. Do you consent to us securely processing your data to create your personalised plan?
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Submit