Wellbeing Quiz

1. About me

My Gender
MaleFemaleOtherPrefer not to say

My Age
18-3031-4041-5051-60Over 60

My Height
cmft

2. My Lifestyle

Which of the following terms best describes your lifestyle?
StressfulVery busyInteresting and variedRelaxedLeisurely

Which of the following best describes your level of physical activity in an average week?
Low (0-1 active days per week)Moderate (1-2 active days per week)Active (3 active days per week)Very Active (4+ active days per week)

3. My Wellness

Which of the following goals are important to you?Please rank each on a scale of 0 - 5, where 0 is not at all important and 5 is very important

I want to be in better shape —Please choose an option—012345

I want to have more energy and vitality —Please choose an option—012345

I want to have a stronger immune system —Please choose an option—012345

I want to be more fit and active —Please choose an option—012345

I want to lose some body fat —Please choose an option—012345

I want to be sure I'm getting all the nutrients I need —Please choose an option—012345

I want to maintain a healthy active weight —Please choose an option—012345

4. How should we contact you?

A member of our team will soon be in touch with personalised recommendations, based on your answers above. How would you prefer them to contact you?
WhatsAppTextEmailPhonecallAny of the above

Please provide at least one means of contacting you.

My name*
My mobile number*
My email address

I am happy to be contacted with personalised nutrition recommendations from any member of the Liberty Wellness team*

Yes! I would like to sign up to receive nutrition and wellbeing recommendations by email from Liberty Wellness

* Required Fields