Coaching for Early, During or Post Menopause Symptoms

Be Healthy, Feel Alive, Be Confident, Feel Young... and Love How You Age!

FIRST STEP
Click On This Link To Fill Out Your Health Evaluation Form!
http://healthyhormones.com.au/forms/evaluation.htm

SECOND STEP
Now answer all the questions below... this is all about you so please be honest with yourself...

Lifestyle Questionaire

Answer the following questions honestly... before you can be healthy and happy you must know what you have to change to find a new balance in your life...

First Name:
Last Name:
Full Postal Address:
Country:
Zip Code:
When is the best time to contact you?:
Best telephone number to contact you:
Email:
Have you had a full blood screen in the last 2 years?:
Have you had a full medical in the last 2 years?:
Have you had a mammogram in the last 2 years?:
Have you had a pap smear in the next 2 years?:
Do you meditate?:
Do you drink alcohol every day?:
Are you on HRT?:
Do you take any medications?:
Do you smoke?:
Do you exercise?:
Do you take vitamins and minerals?:
Do you use chemicals to clean your house?:
Do you use toxic free make-up?:
Do you buy organic food?:
Do you take time out to relax?:
Have you been sexually, physically or mentally abused?:
Do you have a group of female friends that you socialize with?:
Do you have a sweet tooth?:
Do you cry easily?:
Do you laugh often?:
Do you have a faith or religion?:
Do you use natural progesterone?:
Do you have alot of negative stress in your life?:
Are you married or have a full time partner?:
Do you have a regular sex life?:
Do you like food?:
Would you consider yourself to have a weight problem?:
Do you drink water?:

CONGRATULATIONS because when you recognize a problem you are half way to solving it. Watch your emails because I am going to send you a free report on 'creating a life you love' . Have a better than happy day and CLICK HERE to send me a message with any questions you may have and you will receive a reply within 48 hours.

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