Questionnaire - Hello Healthy Clinic

Basic Details

Full Name

Email

Confirm Email

Mobile Number (WhatsApp)

Country / Address

Is it your first time joining our challenges?

YesNo

Where did you hear about this challenge?

Your Motivation

What made you join this challenge?

What do you expect from this challenge?

What has been your biggest struggle when it comes to weight loss or maintaining your weight?

Body & Goals

Date of Birth

Gender

Marital Status

Do you have kids?

YesNo

Height (cm)

Current Weight (kg)

Goal Weight (kg)

Health Information

Do you have any allergies or intolerances?

Other allergies (if any)

Health Conditions

Other health conditions

Nutrition deficiencies if any

Lifestyle

Have you followed a diet in the past?

Do you follow a specific diet?

Activity Level

Do you have time or support to cook meals?

Financial Readiness

Income per month

Busy Life Challenge - Questionnaire