Home
About
Work With Me
Assessment
Blog
Contact

Select Page

YOUR FREE HEALTH AND ENERGY ASSESSMENT

Your Assessment Form

How healthy and energetic do you feel?

Loading...

Step 1 Step 2 Step 3 Step 4 Step 5 Step 6 Step 7 Step 8 Step 9

Step 1

Health Assessment

Tired most of the time

1

2

3

4

5

Disagree........................Agree

Overweight

1

2

3

4

5

Disagree........................Agree

Prone to hormonal symptoms

1

2

3

4

5

Disagree........................Agree

Suffering from poor memory and concentration

1

2

3

4

5

Disagree........................Agree

Step 2

Low or depressed

1

2

3

4

5

Disagree........................Agree

Plagued by dry skin in need of daily moisturisers

1

2

3

4

5

Disagree........................Agree

Having difficulty sleeping

1

2

3

4

5

Disagree........................Agree

Often feeling anxious or stressed

1

2

3

4

5

Disagree........................Agree

Step 3

Prone to indigestion or bloating after food

1

2

3

4

5

Disagree........................Agree

Often constipated (you rarely go twice a day)

1

2

3

4

5

Disagree........................Agree

Suffering from dark circles or bags under your eyes

1

2

3

4

5

Disagree........................Agree

Step 4

Total Score:

Ideal target: 14 or less

Step 5

Energy & Blood Sugar Control:

I still feel tired 20 minutes after getting up

1

2

3

4

5

Disagree........................Agree

I often crave chocolate, sweet foods, bread, cereal or pasta

1

2

3

4

5

Disagree........................Agree

I need tea, coffee or a cigarette, or something sweet to get me going in the morning

1

2

3

4

5

Disagree........................Agree

I often have energy slumps during the day or after meals

1

2

3

4

5

Disagree........................Agree

Step 6

I often crave something sweet/coffee after meals

1

2

3

4

5

Disagree........................Agree

I often have mood swings or difficulty concentrating

1

2

3

4

5

Disagree........................Agree

I get up dizzy or irritable if I go 4 to 6 hours without food

1

2

3

4

5

Disagree........................Agree

I often overreact to stress

1

2

3

4

5

Disagree........................Agree

Step 7

I have less energy than I used to

1

2

3

4

5

Disagree........................Agree

I often feel too tired to exercise

1

2

3

4

5

Disagree........................Agree

I am gaining weight / finding it harder to lose weight

1

2

3

4

5

Disagree........................Agree

Step 8

Total Score:

Ideal target: 16 or less

Step 9

Please fill in your details below

First Name

Surname

Email

Contact Number

Newsletter

Sign me up!

if your score is for over 26 on either scale, there is room for serious improvement!

This is not only how you could be, this is how you should be

I know I can help you get what you want – Don’t wait!

Antje The Sugar Solution

The Sugar Solution

Do you feel you cannot quite kick the habit even though you know that sugar is bad for you?

Get my free e-book and learn how to live sugar-free!

Newsletter Sign Up

Click the box above to sign up to my newsletter. We respect your privacy and will never share your information. Please refer to my Privacy Policy.

Visit Me

Wimpole Therapeutics

2 Wimpole Street

London W1G 0EB

Contact Me

+44 (0) 7803 181164
[email protected]

Social Media

Copyright © 2021 AKHealth | All Rights Reserved | Privacy Policy | Terms and Conditions | Website by Greys Design

Pin It on Pinterest