First Name
*
Last Name
*
Email
*
I Want To Get Better So...
(choose ALL that apply)
I've Been To The Doctor
I've Been To The Endocrinologist
I've Changed My Diet
I've Added Supplements
I'm Deciding What To Do Now
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Primary Reason For Wanting To Control My Thyroid Issues
To Improve My Energy Levels
To Enjoy My Day
To Be Better Able To Work
To Be Better Able To Enjoy My Family
To Lose Weight
To Stop Being A Burden
What Is Your Current Health Situation?
I am healthy and feel good, I just want to feel better
I've been told my tests are normal, but I just don't feel right
I don't feel normal - my health is affecting my daily activities
I feel sick - I'm worried that I will not get better
I want a healthier life and my goal in the next year is...
I want to be more active
I want to lose weight and keep it off
I want better sleep
I want to be able to travel
I want to be able to spend more time with friends and family
I want to be able to spend more time helping my community
I know I have to do something to help my health and...
I currently have the means and finances to invest in my health
I currently have access to finances that I can invest in my health
I want to be able to invest in my health, but don't think I can invest time or finances in my current situation
I cannot invest in my health at this time