1. How often do you consult your physician and for what reason?

2. Have you been diagnosed with :Cardiovascular diseases (hypertension, coronary disease)HyperlipidaemiaHypercholesterolemiaThyroidopathyStrokeDeep vein thrombosisHormonal issuesKidney DiseasesPulmonary DiseaseNeurological diseasesLiver DiseaseIrritable Bowel SyndromeAsthmaAllergiesSkin Diseases

3. Please mention any other diseases not listed above:

4. Do you smoke?
NoYes

4.1 If Yes, how many cigarettes?

4.2 And for how long?

5. Do you have intense physical activity?
NoYes

6. Do you feel fatigue?
NoYes

7. Please mention any medications or supplements that you take

8. What is your main health issue?

9. Has your daily life changed and to what extend?

10. Do you have sugar cravings? NoYes

11. Have you experienced recently difficulties in losing weight?NoYes

12. Have you noticed increased thirst, increased urination or changes in your eating habits?
NoYes

13. Please mention whether you follow a specific diet

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