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If you live in the
CAPE TOWN area,
click here to book
your Free Facial!
New products:
Niteworks
Shapeworks
Nourifusion
Best Sellers:
Formula 1 (NPD)
Protein Powder
Herbal Beverage
Click HERE to listen to a Sports Nutrition talk by Dr Luigi Gratton.
 
The Health Zone
16 Chesterfield Road
Oranjezicht
8001 Cape Town
Tel: +27 21 461 2671
Cel: +27 82 507 7013

Health & Nutrition Survey

Please type in your answer to each question in the block provided. (You can copy and paste your answer)

1 Which of these words best describes your lifestyle?
Calm/Active/Stressed

2. Do you think you get 100% of the daily nutrition needed?
Yes/No
3. Do you take nutritional supplements (vitamins / minerals / proteins)?
Daily/Sometimes/Never
4. Do you experience a loss of energy during the day?
Yes/No/Sometimes
5. Do you or any of your members of your family need to gain or lose weight?
Gain/Lose
6. Approximately how many Kg do you/they need to gain or lose?
7. Do you eat a variety of healthy foods from the basic food groups each day?
Yes/No/Don't know
8. Would you like more information on:-
Sport nutrition/Healthy meals/Appetite control/Skin & Body care
9. What is the best time to call you? Eg 18:00 to 20:00

 

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