Live Keto Fab Introductory Survey
RequiredRequired Question(s)
Required 1.

Preferred name (How would you like to be addressed)?


 

50 characters left.
2.
Please enter the information indicated below.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

Email Address:
emailaddress@xyz.com
City:
State/Province
(US/Canada):

3.

What is your birth month?

 

50 characters left.
Required 4.

What is your birth year?

 

50 characters left.
Required 5.
How did you first hear about the Ketogenic way of eating?
Facebook
Instagram
Other Social Media
Internet Search
Word of Mouth
Other  
  • Comment:

  • 500 characters left.
Required 6.
 How did you hear about Live Keto Fab? 
Facebook
Instagram
Other Social Media
Internet Search
Word of Mouth
Other  
  • Comment:

  • 500 characters left.
Required 7.
What is your primary reason for wanting to explore the ketogenic lifestyle?
Weight management
Improve a disease condition
Mental clarity
Improve energy levels
Other  
  • Comment:

  • 500 characters left.
8.
What is your favorite meal to cook? (do not consider calories or nutrients)


 

50 characters left.
9.

 What is your favorite restaurant?


 

50 characters left.
10.

 

What is your favorite meal to order out?


 

50 characters left.
11.

How many times do you eat per day?

1
2
3
4
5
6
12.
What is your typical breakfast, lunch, dinner and snack?
 

350 characters left.
13.

 Do you meal prep?


Yes
No
14.

 Are you responsible for preparing meals for others in your household?


Yes
No
15.

How frequently do you exercise each week?

1 to 2 times
3 to 4 times
5 to 6 times
7 or more times
Less than 1 time
Other  
16.

If yes, what type of exercise do you engage in?

Running/walking
Weight Lifting
Yoga
General Cardio
Other  
Required 17.

Do you have any food sensitivities?

Lactose intolerance
Gluten sensitivity
Nut allergy/sensitivity
Berry allergy
Egg allergy/sensiivity
Other  
  • Comment:

  • 500 characters left.