"Before Herbalife I had struggled all my life to gain weight. At one stage I even went on the 'Ice Cream Diet'...This had absolutely no effect on my weight" Click here for success story

This questionnaire has been designed to establish your personal requirements for gaining weight. Please answer all of the questions below by ticking the appropriate box.

 Experienced consultants, from the worlds largest weight management company, available to offer advice on how to gain weight through obtaining better absorption, by taking additional nutritious calories and fuelling and refuelling around exercise.

1.What are your meal patterns like 

3 meals a day

More than 3 meals a day

Irregular meals

Less than 3 meals a day

2.Food consumed. Do you

Eat lots of food and not put on weight

Have a poor appetite

3.Can you run through a typical daily diet:

Breakfast e.g. cereal/toast

Mid morning e.g. fruit, chocolate bar

Lunch

Mid afternoon

Dinner

After dinner

4.What are your energy levels like

Below average

Average

Above average

5. Do you smoke?

Yes No

6.Give yourself a rating on negative nutrition (smoking, coffee drinking, fast food, processed food, stress, medication) out of 10. High negative nutrition = low number.

7.Have you tried to gain weight before? If so how?

8.Do you play sports or exercise or go to the gym? Please advise details. This is so we can advise how to take the products around exercise i.e. fuelling and refuelling

9.What type of work do you do i.e. office work or physically demanding work?

10.How old are you?

11.How tall are you?

12How much do you weigh?

13.How long have you been at this weight

14.What is your ideal goal weight?

15.Addditional information e.g. general health:

166.How much would you be prepared to spend per day to achieve your goal?

Less than £1.00

£2.00

£3.00

£4.00

£5.00

17.How serious would you say you are about your gaining weight?

1. Extremely serious              
2. Fairly serious                    
3. It doesn't really worry me   

18.How serious would you say you are about maintaining long term good health by looking after your body now?

1. Extremely serious              
2. Fairly serious                    
3. It doesn’t really worry me   

Information required:  Recommended programme? Questions you need answering?  Anything not clear on the web site? Prices Success stories

Name 

Email 

Telephone Evening 

Telephone Day

Which part of the country are you from?

Best time to call Telephone advice between 9am -9 pm on landline telephones. And on Saturdays between 10am and 4pm. If your "hard to contact" or don't have a landline number please call us on 01932 889236. Please contact us at least 30 mins after sending the questionnaire.

Please check your contact details or we cant help you. Please check that have completed information required box.