60 Sec Health Survey

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Let's Drink & ShrinkTM

LOSE 5 POUNDS IN 5 DAYS

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Q&A
60 Sec Health Survey

Home
Order
Q&A
60 Sec Health Survey

60 Second Health Goals Survey

Name*

Email Address*

Phone Number* (to receive FREE samples)

Birthday *month/day/year free samples in your b-day month.

What are your weight loss goals?

5-10 pounds15-20 pounds25 or more pounds

I can commit to a 30 day system to reach my health goals.

YesNoI only want to lose 5 pounds in 5 days

I currently take multi-vitamins and/or fiber supplements. Check aal that appley.

One a DayNature MadeGarden of LifeFiber SupplementsOtherI don't currently take multi-vitamins or fiber supplements.

I currently take medication for the following. Please check all that apply.

ThyroidDiabetesHeart MedicationHigh Blood PressureNone of these

The sweetness level of the Let's Drink & Shrink Formula can be customized. Which do you prefer?

Little SweetVery Sweet

The Let's Drink & Shrink Formula can come how you like it. Which do you prefer?

Drink - Like Kool-AidJuice - Like a Smoothie

I have to avoid the following sweeteners.

SteviaSucraloseAspartameI do not have to avoid any of these sweeteners.

I have IBS (Irritable Bowel Syndrome).

YesNo

I have trouble controlling my appetite?

YesNoSometimes

I make healthy eating choices.

YesNoSometimes

I need to eat more fruits and vegetables.

YesNo

I often eat junk (processed ) foods like chips, cookies, etc.

YesNoSometimes

I'm interested in all natural products that can help me with the following: Please check all that apply.

Weight Loss & DetoxingFatigue (My Energy)Weight GainPainAnxietyBetter SleepBetter Gut Health (Probiotics)Whiter TeethBetter Skin

I use and know the many health & wellness benefits of essential oils.

YesNoI'd like more info

I may be interested in a Health & Wellness Coach to keep me motivated and suggest the best products to help me reach my goals.

YesNoMaybe, I'd like more info.

I'm interested in getting healthy and getting paid $50-$100 dollars a day to help others do the same.

YesMaybe, I'd like more info.Not at this time, but I will refer others.

How did you learn about Let's Drink & Shrink? Please check one below.

Paula ReedBrittany ClaybrookYoshua ClaybrookShalisha RichardsonTonya WilliamsShar WatkinsBridget "Brie" Byrd

Message

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Feeling out this 60 second survey will allow us to make sure we are recommending the best and most beneficial Let's Drink & Shrink System for you to meet your personal goals.

We understand that your health journey is very specific to you and we do not take that lightly. This is why all products are all natural and come with a 30 day money back guarantee.

Phone: (404) 925-6533

Email: [email protected]

Address: Atlanta, GA 30281

​Let's Drink & ShrinkTMLOSE 5 POUNDS IN 5 DAYS

60 Second Health Goals Survey

Let's Drink & ShrinkTM

LOSE 5 POUNDS IN 5 DAYS