Test Healthy

Your Name (required)

Your Email (required)

Age (required)

Phone number:

1.Evaluation of your health (on a 5-point scale):*
Excellent Good Satisfactory Unsatisfactory Bad 

2.How much water do you drink per day *Up to 1 liter ( 30 oz) Up to 1.5 liters (45 oz) Up to 2 liters (65 oz) Up to 3 liters (130 oz) 

a) Your weight in pound/kg: (required)
Pound Kg 

b) Your height in feet and inch/cm: (required)
Feet and inch Meter 

3. How regularly do you partake in anti parasitic cleansing of the body.
1. Every six months 2. Once a year 3. Rarely 4. Never 5. I do not remember 

4. Mark the signs of intoxication that you have:
a) Fatigue and depression
Yes No 

b) Insomnia
Yes No 

c) Bloated, painful or hard stomach
Yes No 

d) Excessive weight, underweight, poor appetite, swelling
Yes No 

e) Spots on the skin, yellowish complexion, dark circles under the eyes
Yes No 

f) Brittle hair and nails
Yes No 

g) Shortness of breath, coated tongue, unpleasant body odor
Yes No 

h) Cold hands and feet
Yes No 

i) Headaches
Yes No 

j) Lower abdominal pain
Yes No 

k) Irregularity of the menstrual cycle
Yes No 

l) Allergies
Yes No 

*If you possess 3 or more of these symptoms of intoxication you may be at risk of toxic poisoning (poisons, toxins, stones, slime, worms, fungi, etc.), development of dangerous diseases and accelerated aging!*

5. How many people are in your inner circle of family and friends, whose health and future you greatly care about?*

6. Are you ready to take one of our educational courses:?*
Yes No 

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