Healthy Aging Personal Assessment

Upon receipt of this completed questionnaire our product experts will make appropriate product suggestions via email. These are not automated responses. All submitted information will be treated confidentially. We respect your privacy and do not rent or sell your personal information to third parties. Read our complete privacy policy.
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Gender: male female

What best describes your age category?
12-16   17-21   22-30   31-40   41-50   51-60   61-70   70+

How many times a week do you exercise?   0   1-2   3-4   5+

How is your stress level at work?   little   moderate   high   very high

How is your stress level away from work?   little   moderate   high   very high

Do you smoke?  yes   no

Do you drink alcohol?   yes   no

How many hours of sleep do you get per night?   2-4   5-6   7-8   8+

Do you wake rested?  yes   no     

Do you snore?  yes   no

Do you suffer from fatigue?  yes   no

How often are you fatigued?   never   1 day a week   2-3 days   4-5 days   5+ days

How often do you have bowel movements?
1 per day   2 per day   3+ per day   1 every other day   less often

How much water do you drink per day in ounces?
0-8 oz   8-16 oz   17-24 oz   25-32 oz   33-48 oz   48+ oz

Do you consume 5-7 servings of vegetables and fruit per day?  yes   no
Do you take a daily multivitamin? yes   no
Do you take daily antioxidants? yes   no
Do you take a natural immune supporter? yes   no



At VRP we believe the foundation to any supplement program begins with a quality multi-vitamin. In fact one of the ways VRP is unique is that we DO NOT put “window dressing” vitamins in our condition specific formulas. Our modular approach allows you to utilize the benefits of multiple formulations without the worry that you are receiving too much of any nutrient. » Read more about this

Your product suggestions will be sent via email from Healthy Aging. These are not automated responses, although often people’s needs are similar. Our product experts will review your information and you should receive your response within 3 - 5 business days.

Vitamin Research Products values your privacy and the confidentiality of the information you choose to share with us. The information you provide here will be used for the sole purpose of facilitating appropriate product suggestions.

Information provided is for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. You should not use the information provided for diagnosing or treating a health problem or disease or prescribing any medication or other treatment.

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