☘ FINLANDIA

Quick Health Snapshot

Free, 2–3 minutes. Answer a few short questions so our team can prepare the right guidance for you.

Questions marked with an asterisk (*) are mandatory.

Your contact details

We use these to reach you and prepare your guidance.

Last name

First name

Phone

City

What would you most like to improve?

Choose up to 3.

High blood pressure High cholesterol Weight Blood sugar Sleep Stress Digestion Joints Skin Hormones Nutrition & supplements Chronic fatigue Post-surgery care Cancer support Adolescent stability Other

Maximum 3

Please describe your other concern

Medications & supplements

Are you currently taking prescription medication?

No Yes

How many different prescription medications?

1 2-3 4-5 6+

About how many pills per day in total?

1-2 3-5 6-9 10+

Do you take any supplements?

No Yes

How many different supplements?

1 2-3 4-5 6+

About how many supplement servings per day?

1-2 3-5 6-9 10+

Lifestyle (optional)

All optional — answer what you can.

Meals eaten out per week

0-2 3-5 6+

Servings of vegetables per day

0-1 2-3 4+

Servings of fruit per day

0 1 2+

Exercise sessions per week

0 1-2 3-4 5+

Sleep quality (1 = poor, 10 = great)

Poor Great —

Energy level (1 = low, 10 = high)

Low High —

Stress level (1 = low, 10 = high)

Low High —

Health context (optional)

Pregnant or breastfeeding?

No Yes Not applicable

Any important allergies?

What kind of help are you looking for? (optional)

Which consultation would you like? (optional)

Times and prices below are tentative — final details posted in-store.

Finlandia Coffee — Wed 9:30am (group)

A casual group session over coffee.

Finlandia Tea — Thu 12pm (group)

A midday group session over tea.

Finlandia Potluck — Fri 11am–1:30pm (group)

A bring-a-dish group gathering.

Medication review — $250/session (partially gov-covered)

A one-on-one session with a pharmacist.

Not right now

I would rather not book a consultation yet.

What matters most over the next 5 years? (optional)

Independence Keep working No more medications Cardiovascular health Mobility Brain health Weight control Extend healthspan Ability to do activities I enjoy Pursue life goals Acne gone for good Continue aesthetic treatments Life

to years

Anything else you would like us to know? (optional)

Your information is strictly confidential and used only for Finlandia wellness guidance.

✓

Thank you!

A Therapeutic Nutrition Consultation may be appropriate for you.

Consultation options you can choose from:

Finlandia Coffee — Wed 9:30am (group)
Finlandia Tea — Thu 12pm (group)
Finlandia Potluck — Fri 11am–1:30pm (group)
Medication review — $250/session (partially gov-covered)

Our team will contact you shortly.