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Health Check Form – Step 2
Wonderful
! At this step, we would like to know about your objective of the retreat.
STEP 2:
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A problem was detected in the following Form. Submitting it could result in errors. Please contact the site administrator.
Do you already have fasting/Detox experience?
Yes
No
How many times have you done fast/detox before? ……..times.
How long did you fast? max …….days?
When was the last time you fasted? Month / Year
How did you do the fast?
Homebased/alone
In a group in my hometown
In a retreat with others
In a resort alone or with a partner
Where did you do the fast?
In Vietnam
Outside of Vietnam
In...
What do you want to achieve with fasting, what are your goals? (Multiple choices, choose up to 8 choices)
Loose weight
Get rid of toxins
Reduce joint pain
Reduce inflammation.
Improve sleep quality
Reduce dependence on medication
Reduce pain
Improve digestion
Overcome menopause symptoms
Change unhealthy habits
Embrace healthier lifestyle
Improve a chronic disease
Feel more vigour and energy
Reduce blood pressure
Improve skin appearance
Relax
Recover from a traumatic event
Disease prevention
Overcome addiction
Change of eating habits
Please share here with us what you want to focus on during the retreat? (200 words)
Do you consider yourself fit and healthy?
Yes
No
If not, what restrictions do you have?
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