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Start With Your Health Survey
Health Survey
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DietnCure Health App
: :
Health Survey
DietnCure 2 Min Health Survey
Fill in this quick survey for any possible vitamin deficiencies that can be easily managed with the right foods.
What is your current weight?
What is your height?
Do you have any of the following medical history?
Diabetes
Thyroid
Hypertension
PCOD
Cholesterol
For Females - Are you planning to conceive?
Yes
No
Are you experiencing post pregnancy weight gain?
Yes
No
Tick mark if you are experiencing any of the following:
Vitamin A Deficiency
Night vision deterioration
Dry Eyes
Eczema
Scaly Patches & Dandruff
Acne Issues
Hypothyroidism
Weight gain
Hairfall
Breathlessness
Fatigue
PCOS
Hairfall &Mood swings
Weight gain ,skin issues
Hirsutism
Irregular Period
Frequent and Heavy Menstrual Periods
Diabetes Onset
Excessive Hunger and Fatigue
Excessive Thirst
Peeing More Often Than Usual
Dizziness (uneasiness)
Delayed wound healing
Hairloss
Vitamin D Deficiency
Muscle Weakness, Muscle Ache & Cramps
Bone or Joint Pain (soft bones )
Easy bruising or bleeding
Fatigue & Low Energy
Dry Skin and Hair
Excessive Sweating
Vitamin B Deficiency
Weakness, Tiredness, Light-Headedness
Shortness of breath or tingling feet
Experiencing Forgetfulness
Dry and Coarse Hair
Impaired balance
Frequent Headaches
Poor Gut Health
Iron deficiency
Flat Fingernails
Restless Legs
Pale skin &loss of appetite
Hairfall
Mood Changes & Depression
Vitamin C Deficiency
Bleeding gums
scurvy
Poor wound healing (sores that last for a long time)
Blemishes (skin problem )
Name
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First
Last
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