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Home
How It Works
Success Stories
Payment Plans
Contact Us
Blog
Home
How It Works
Success Stories
Payment Plans
Contact Us
Blog
Menu
Home
How It Works
Success Stories
Payment Plans
Contact Us
Blog
Are You A Candidate?
Symptom Questionnaire
1. Please Enter Your Name.
2. Please Enter Your Phone Number.
3. Please Enter Your Email
4. Please Enter ZIP Code
5. Do you suffer from hot sweats during the day?
Yes
No
6. Do you suffer from night sweats?
Yes
No
7. Do you have thinning hair and/or thinning eyebrows?
Yes
No
8. Do you have fatigue on a regular basis?
Yes
No
9. Do you crave sugar or salt?
Yes
No
10. Do you experience bloating daily?
Yes
No
11. Do you have difficulty sleeping?
Yes
No
12. Have you tried to lose weight but have been unable to do so?
Yes
No
13. Do you have poor eating habits?
Yes
No
14. Do you have low energy daily?
Yes
No
Am I A Candidate?
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