Quiz – Enhanced MD

Age

Gender

Current Weight (lbs)

Height (ft/in)

Lose weight Boost energy Balance hormones Regrow hair

Less than 6 months 1-2 years 3+ years

Diets Exercise Medications None

Diabetes Hypertension Thyroid conditions Heart disease None of these

Yes No

Average hours of sleep per night

Alcohol intake per week

Do you smoke?

1 Not ready 2 Somewhat ready 3 Moderately ready 4 Very ready 5 Extremely ready

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Starting at $245/month

First Name

Last Name

Email Address

Mobile Number

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