Retreat Questionnaire | LongevityHealth

First name

Last name

What are your main health, wellness or body goals while at the retreat?

Do you have any food restrictions or allergens? Any special dietary requests? Please specify.

Are you okay with both chicken and fish? If not, please specify what is your preferred protein source.

Are you okay with cheese/dairy? eggs? (If not, please specify).

Are you okay with eating 2 full meals/day + a snack? (If not, please specify)

Tell us about your fitness level. How often do you exercise? Do you do yoga?

Do you have weightloss goals? If so, what is your height and weight.

Do you have any heart or blood pressure issues?

Any other medical issues we should know about?

Retreat
Questionnaire