1
2
3
4
5
What is your main concern?
Wrinkles
Saggy skin
Weak nails
Brittle hair
How severe is your concern?
Mild
Moderate
Severe
Very severe
Which of the following best describes
your lifestyle?
Active and adventurous
Balanced and moderate
Laid-back and relaxed
What is your skin type?
Normal
Oily
Dry
Combination
Do you currently take, or have you ever taken, any vitamins or dietary supplements?
Yes
No
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