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Health Consultation - Let us help you!

Let us assist you in selecting the nutritional and/or personal care products that may help you.  All information submitted will remain private and confidential.

1. What are you looking for in your search for good health?
  
 
    
  
2. If looking for weight management, how much weight are you serious about losing/gaining?
  
 
Weight to Lose / Gain:       
Your Current Weight:       
Your Height:      
Your Age:     years
  
3. Do you suffer from any health issues? e.g. digestive problems, high BP, diabetes etc... (please list below)
  
 
  
4.  If required, check the boxes that best describe your skin. (select those that apply)
 
 
  Dry / Sensitive   Normal / Combination   Oily 
 
    
5.  Please enter the following contact information.
    
Name:  
Email Address:  
Phone - Day:   (please include full area code)
Phone - Evening:  
Postal Address:   (we can send information via mail, if required)
Town / City:  
State or Area:  
Zip / Postal Code:  
Country:  

Please indicate the best day / time to contact you: 
Contact Option 1:  (e.g. Weekdays, Morning 9am - 12pm)
Option 2: 
Option 3: 
 
    
7.  Are there any additional comments you wish to add to aid our evaluation of your health needs?
   
 
   
8.  Please submit your results.
 
 
 
Your contact consultant is:
Name:Carolyn Fielden
Phone:08 9725 9118   or  0421 648 010
Email:

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Carolyn Fielden (44 929 682 491), 28 Travers Drive (Bunbury) Australind WA 6233, Australia
An Independent Herbalife Distributor - www.sohealthy.com.au Copyright 2014

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Products Available in Argentina, Australia, Austria, Belgium, Bolivia , Botswana , Brazil, Bulgaria, Canada, Chile, China, Colombia, Costa Rica, Croatia, Cyprus, Czech Republic, Denmark, Dominican Republic, Ecuador, El Salvador, Estonia , Finland, France, Germany, Ghana, Greece, Guatemala, Honduras, Hong Kong, Hungary, Iceland, India, Indonesia, Ireland, Israel, Italy, Jamaica, Japan, Korea (north), Korea (south), Latvia, Lesotho, Lithuania , Macau, Malaysia, Mexico, Namibia, Netherlands, New Zealand, Nicaragua, Norway, Panama, Paraguay, Peru, Philippines, Poland, Portugal, Puerto Rico, Romania, Russia, Singapore, Slovak Republic, South Africa, Spain, Swaziland, Sweden, Switzerland, Taiwan, Thailand, Turkey, Ukraine , United Kingdom, United States, Venezuela, Vietnam, Zambia

Updated: 21-Jan-2014
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