Performance Check – E

Here you can check how vital you are. Would you like to live healthier, with more energy, better sleep and a fit immune system? Then please answer the questions below. Of course, we will treat your information confidentially. You will receive the evaluation with the resulting recommendations for ACTIVEfit, HEALTHYeating and MENTALLYstrong immediately, without obligation and of course free of charge.

What do you want to achieve? *

• A healthier and fitter way of living
• More energy and well-being
• Detoxificaton and building up your metabolism
• Better sleep and regeneraton
• Get and stay slimmer
• A more effective immune system

(please click on the appropriate box)

Do you often wake up in the morning without energy and drive? *

• Yes
• No

Do you often feel exhausted and/or have energy hole? *

• Yes
• No

Do you suffer from headaches? *

• Yes
• No

Are you often irritable, nervous or depressed for no reason? *

• Yes
• No

Do you sometimes have problems with concentrating or remembering? *

• Yes
• No

Do you eat less than 5 portions of fresh fruit, vegetables and salad every day? *

• Yes
• No

Are you susceptable to colds or infections? *

• Yes
• No

Do you have problems with your digestion, stomach or intestines? *

• Yes
• No

Are there any foods that you cannot tolerate? *

• Yes
• No

Do you regularly suffer by allergies like hay fever? *

• Yes
• No

Do you often eat outside, e.g. in canteens/snack bars or do you use convenience food? *

• Yes
• No

Do you have problems of falling asleep and/or staying asleep? *

• Yes
• No

Do you often suffer from muscle and/or leg cramps? *

• Yes
• No

Do you have problems with your skin, hair and/or nails? *

• Yes
• No

Do you often feel stressed and under pressure? *

• Yes
• No

Are you exposed to increased electro smog from technical devices? *

• Yes
• No

Especially for women: Do you have a lack of well-being during menstruation / menopause? *

• Yes
• No

Do you have problems after exercising? (regeneration / muscles / joints) *

• Yes
• No

Are you older then 40 years? *

• Yes
• No

Do you need regularly medication? *

• Yes
• No

Have you ever had to seek treatment for your cardiovascular system? *

• Yes
• No

Do you smoke? *

• Yes
• No

Do you wish to change your figure and your body weight? *

• Yes
• No

Would you like to boost your fat burning and metabolism? *

• Yes
• No

Do you often eat irregularly and/or under time pressure and have long breaks between the meals? *

• Yes
• No

Do you drink less than 2 liters of water a day? *

• Yes
• No

Would you like to be able to bridge eating breaks sensibly and safely while on the go? *

• Yes
• No

Do you take care of children / grandchildren / senior citizens in your household? *

• Yes
• No

Is it difficult for you to make fruits, vegetables and salads tasty for your family? *

• Yes
• No

Does your child have concentration problems? (school / homework) *

• Yes
• No

Do family members react with allergies / intolerances to food or environment? *

• Yes
• No

If so, then which ones?

How much is your well-being worth to you per day?

• 3€
• 4€
• 5€
• Or more per day

Name *

Vorname

Nachname

E-Mail *

Phone

Can we contact your via WhatsApp? *

• Yes
• No

I agree to be contacted via WhatsApp to receive information and support for the evaluation, planning, and organization of my request. Further details can be found in the privacy policy.

When is the best time to contact you? *

• before noon
• at noon
• in the evening

Who invited / recommended you? *

DSGVO-Agreement *

• By submitting this form, you confirm that you have read our privacy policy and that you agree to the storage of the data you have entered!

Absenden

We store your data only for consulting purposes and delete the data after 6 months.