Which Cleanse is Right for Me?
Now time to find out which cleanse is right for you with our
Which Cleanse Is Right for Me Questionnaire!

There are many different cleanses on the market, and a variety of factors to take into account when choosing the one that is right for you.


Please, fill out our questionnaire and submit it to our staff for review. We'll be in touch with you soon to help you decide which cleanse is right for you!

1. Age*

2. Sex

3. Do you Smoke?

4. Are you Overweight? If NO,
skip questions 5 and 6

5. How much weight would you like to lose*

6. Which of the right statements best
describes your weight loss style?

7. Are you under a lot of stress at home
or at work?

8. Do you exercise? If No, go to Question #10

9. How often do you exercise?*

10. Have you ever done any other type of
Cleanse? If NO, go to Question 12

11. What Cleanses have you tried in the past?

12. Did you feel that you had a "successful" Cleanse?

13. Are you a coffee drinker?

14. Can you give up coffee for a 30 day period?

15. Are you a tea drinker?

16. Do you have a tendency toward constipation?

17. Do you sleep well at night?

18. Are you a person with an irregular schedule?

19. Are you a snacker?

20. Do you have a nut allergy?

21. Are you Diabetic?

22. In general, are you sick a lot?

23. Are you Lactose Intolerant?

24. Do you have digestive problems?

25. Is eating (not drinking a shake/beverage)
at dinner time important to you?

26. Is developing lean muscle mass important
to you?

27. Do you have a lot aches and pains?

28. Are you on any blood thinning medications?

29. Do you have thyroid issues?

  Name*

  Phone*

  Email*

     

All submissions will be treated confidentially.
Our Staff will evaluate your answers and recommend cleansing products based on your lifestyle, your weight loss and wellness goals and current health challenges.

Please note that we are not doctors, merely individuals with a lot of experience in Cleansing. We can help guide you in the right direction, but it is always recommended that before you begin any cleansing program that you consult with a medical professional.

 

 
The Cleansing Authority > Which Cleanse Is Right For Me? > Questionnaire
 
 
WE ARE NOT DOCTORS! The statements on this website have not been evaluated by any government agency and are not intended to medically diagnose, treat, cure or prevent any disease. All of the information on this site is based on my personal research, information from and opinions of experts in various fields, and my personal experience, and the experience of many others using the various cleansing products. Before beginning any Cleansing or Weight Loss Program, you should always consult a medical professional.
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