Natural Life Foods Professionals

The professionals choice for vitamins, herbs and nutritional supplements

 

 

 

 

Copyright NLF Pros 2006
Website by Classic Insight

Answering the following questions will help us provide information to assist you in choosing nutritional products, vitamins, herbs, and homeopathic products to promote your good health.

 

 

 

 

 

 

 

Natural Life Foods Professionals does not prescribe or diagnose any medical condition, and we do not make any medical claims about any of our products. We recommend you see your medical doctor if you are being treated for any prolonged illness or medical condition.

 

 

 

 

 

 

 

Contact Information (*minimum name & e-mail required):

*Name: 

Address: 

Telephone: 

*E-Mail: 

 

 

 

 

 

 

 

Personal Information (*all fields required):

 

*Sex: 

 Male Female

*Age: 

*Height: 

*Weight (approx): 

 

 

 

 

 

 

 

Dietary Habits:

 

 

 

Do you drink soda or coffee?

Do you eat meat or chicken?

Do you eat dairy products?

Do you eat starches (rice, pastas, bread)?

Do you eat fresh vegetables?

Do you eat frozen vegetables?

Do you eat fresh fruit?

Do you eat organic foods?

Do you eat any raw or uncooked foods?

Briefly ... please describe your daily diet and what food you eat:

  

 

 

 

 

 

 

 

General Health Questions:

 

 

 

Describe your stress level: 

Describe your general health: 

Describe your physical activity: 

How often do you go to the gym? 

How often do you run? 

How often do you swim? 

Describe any other activities: 

Briefly ... please describe your health concerns and your goals:

  

 

 

 

 

 

 

 

NOTE: Our staff will strive to respond to your questions and communicate with you by Email within 72 hours.

Please wait at least two (3) business days from the date you submit this questionnaire before calling (925) 932-1292. We will do our best to try and respond to your health concerns in a timely manner.

Disclaimer: These statements have not been evaluated by the Food & Drug Administration. Any product recommended is not intended to diagnose, treat, cure, or prevent any disease. Should you have any type of prolonged illness, we suggest you immediately consult your physician or medical care provider.