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Questionnaire

Thank you for considering SYNC Life to support your wellness journey. Please take a few moments to complete these 12 questions to help us understand your current health, goals, and challenges. This will only take you 5 minutes to complete. Your responses will enable us to tailor our services to best meet your needs.

What specifically brought you into SYNC Life today? *

What are your primary wellness goals? *

Weight loss

Better sleep quality

Stress reduction

Improved digestion and gut health

Increased physical fitness

Improved energy levels

Enhanced mental clarity

Hormone balance

Anti-aging and skin health

Other

Please select all that apply

If other, please explain your goals:

Which of the following best describes your current stage in your wellness journey? *

Just starting to explore wellness options

Actively making some lifestyle changes

Consistently practicing healthy habits but looking for more guidance

Maintaining a well-established wellness routine

Bringing my wellness routine to the next level using a more science-based approach

Other

Please select one

If other, please explain your current stage in your wellness journey:

What specific health concerns or conditions are you currently managing? *

Chronic pain

Fatigue

Digestive issues (e.g. bloating, constipation, diarrhea, reflux)

Hormonal imbalances

Autoimmune conditions

Weight management

Mental health issues (e.g, anxiety, depression)

Cardiovascular

Other

Please select all that apply

If other, please explain your health concerns:

Which symptoms do you experience regularly? *

Headaches or migraines

Insomnia or poor sleep

Low energy or fatigue

Skin issues (e.g. acne, eczema)

Brain fog

Muscle or joint pain

Anxiety or stress

Digestive discomfort

Low sex drive

Other

Please select all that apply

If other, please describe your symptoms:

How often do you feel less than optimal in your daily life? *

Daily

Once a week

Rarely/Never

Several times a week

Occasionally

Please select one

Are you struggling to complete daily tasks like: *

Being productive at work

Being present with your family

Having the energy to exercise

Maintaining a social life

Managing household chores and cooking

Enjoying hobbies or recreational activities

Other

Please select all that apply

If other, please explain what you are struggling with:

What motivates you to seek support for your wellness journey now? *

Recent health scare or diagnosis

Recommendations from a healthcare provider

Desire for improved quality of life

Realization of the importance of preventative care

Influence from friends or family

Increased awareness of wellness benefits

Experiencing chronic symptoms or discomfort

Please select all that apply

On a scale of 1 to 10, how motivated are you to make lifestyle changes to improve your health and wellness (1 being not motivated at all, 10 being extremely motivated)?

Please select a number between 1 and 10

If there was one thing that we could help you with immediately, what would that be? *

I agree to terms & conditions provided by SYNC Life. By providing my phone number and email, I agree to receive messages from SYNC Life.

I would like to receive promotional texts and emails from SYNC Life *

Yes

Please select one