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Step
1
of 11
Your Name
*
Email Address
*
Phone
City
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Age
Under 18
18 – 24
25 – 34
35 and above
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Gender
Male
Female
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How often do you work out?
4–7 days (Fitness enthusiast)
2–3 days (Weekend warrior)
0–1 day (Getting started)
any is How
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When do you feel most drained?
Mornings
Afternoons
Post-workout
All day
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What’s your biggest struggle?
Low motivation
Muscle soreness
Mental fog
Stress overload
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How do you feel about herbal supplements?
I take them daily!
I’ve tried a few
Never tried, but curious
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How well do you sleep at night?
Excellent
Fair
Poor
I struggle a lot
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How would you describe your overall health?
Excellent
Good
Fair
Poor
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How clean is your current diet and lifestyle?
Very clean
Mostly clean
Somewhat clean
Not clean at all
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Have you used any of Kaya products?
Plain Shilajit Gummies
7-in-1 Shilajit Gummies
Elderberry Shilajit Gummies
Mango Shilajit Gummies
Power Drops
Sea Moss & Elderberry Gummies
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