Personal Renewal Guide

What we are offering hasn't just fallen from a tree. The science behind our support is focused on increasing the body''s repair and decreasing it's breakdown. This 'Personal Renewal Guide' helps us to understand your situation in order to guide you personal cellular renewal experience.

INSTRUCTIONS:
Choose the statement score which closely applies to your situation.
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ENTRY SUGGESTIONS:.
Keyboard Guide: Hitting the [ Tab ] helps to advance through the form. Hit [ Space Bar ] to accept box statements. Or Use your Mouse

Estimated time: 3 min. Questions about this or Univera? Call me at 786-329-9732

* Required

N1 R1 - I am utilizing preventative health strategies. * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: You take vitamins, but irregularly . . . that would be a '2'

N2 R2 - I am motivated to be physically healthy * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

N3 R3 - When I am stressed I don't think clearly * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: Simple addition mistakes on your tax form, several times =)

N4 - Relieving stress would improve my life's quality * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: More calm and peaceful in spite of the day's surprises

N5 - Stress contribute to my weight gain * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: I eat to relieve my stress, nerves

N6 - I'm recognizing hormonal changes taking place * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

N7 - Menopausal (men & women) symptoms are affecting my daily activities * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

N8 - I don't eat the recommended amount of fruits and vegetables per day * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: 5 servings of fruits and vegetables

N9 - I could use nutritional support for my busy lifestyle * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

N10 - I am not happy with my current weight * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: My clothes are tight and uncomfortable

R4 - My joints feel sore after minor activities * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: Walking around the block . . . hurts

R5 - My joints and/or muscles are sore after physical activities * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: Playing Basketball with the kids

R6 - I experience irregularity on a weekly basis * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

R7 - I have digestive disorders and stress * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

R8 - I could benefit from products which support healthy digestion * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

R9 - I could benefit from products which moisturize and support skin integrity * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: Alligator skin, skin that easily breaks and flakes

R10 - I use products to protect my skin from environmental exposure * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

V1 F1 - I feel anxious about my health * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

V2 - At times I have a negative attitude * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: Having an unreasonably funky, down mood

V3 - Lack of energy results in my hanging back for certain activities * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: I seldom do activities which I used to do without a thought or concern

V4 - I rely on caffeinated drinks to maintain my energy level during the day * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: I use Red Bull, coffee, coffee cubano, espresso, coke, etc.

V5 - I feel fatigued especially in the afternoon * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply You want to find a place to take a nap during working hours; hard to focus on your work

V6 - My cognitive performance and memory have declined * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: I forget more things now than I used to

V7 - I find it hard to focus and concentrate * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example: I become Easily distracted

V8 - I want to live to the fullest regardless of age * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply Example:I want to discover my part for being more vital and energetic

V9 - A good night's sleep is getting harder to find * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

V10 - I do not feel rested when I awake * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

F2 - I am proactive about my diet * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

F3 - I generally suffer from colds and flu during the winter * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

F4 - I want to proactively support my immune system * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

F5 - I am less healthy than I expected to be at my current age * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

F6 - I am not sure about antioxidants and how much I need daily * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

F7 - I don't always eat a balanced diet * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

F8 - Proper diet is a concern to me * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

F9 - I drink more than 3 alcoholic beverages per week * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

F10 - I smoke * (3 ) Strongly Applies (2) Somewhat Applies (1) Doesn't Apply

Your Name Please * First and Last

I would like to see the results of this Personal Renewal Guide and how Univera's Nutraceutical science can help. Contact me. * Share your contact information, a convenient date(s) and time(s) to contact you for 'Cellular Renewal' /metabolic coaching.

Did you find this guide helpful? *

Any well-being issues you are concerned about or have appeared to have changed/improved/got worse? * Example: My left knee mobility . . . (no disease states please)

I understand that FDA has not apporved of any thing said here and that we do not diagnose, heal or cure any diseases.

I understand
I don't understand
Other:

Please share my PRG results with a health coach. * Purpose: To provide background information

Yes, I want to benefit from the experience of others
Maybe. Let's talk first.
Let's just keep this between you and me for now.
Definitely not
Other:

I would like my friends to enjoy the benefits of Univera's Metabolic Supplementation.

Maybe after more due diligence
Yes, contact me
Maybe, contact me
Other: