VITALITYGRACE — WELLNESS QUESTIONNAIRE 

VITALITYGRACE — WELLNESS QUESTIONNAIRE 

A gentle guide to help you choose the supplements that best align with your rhythm. 

Shape 

✨ INTRODUCTION 

At VitalityGrace, we believe your wellness journey is beautifully personal. 
This questionnaire helps you explore your energy, sleep, digestion, skin, and daily rhythm so we can guide you toward the supplements that best support your lifestyle. 

This is not a medical assessment — simply a gentle tool to help you understand what your body may benefit from in everyday life. 

Take a breath, answer honestly, and move at your own pace. 

Shape 

SECTION 1 — ENERGY & VITALITY 

  1. How steady is your energy from morning to evening? 
    ☐ Very steady 
    ☐ Mostly steady 
    ☐ Afternoon dip 
    ☐ Often tired 

  1. Do you experience afternoon fatigue? 
    ☐ Never 
    ☐ Sometimes 
    ☐ Often 

  1. How often do you feel mentally foggy? 
    ☐ Rarely 
    ☐ Sometimes 
    ☐ Often 

 SECTION 2 — SLEEP & RECOVERY 

  1. How long does it take you to unwind in the evening? 
    ☐ Quickly 
    ☐ Moderate 
    ☐ Hard to unwind 

  1. Do you wake during the night? 
    ☐ Rarely 
    ☐ Sometimes 
    ☐ Often 

  1. Do you feel refreshed in the morning? 
    ☐ Yes 
    ☐ Sometimes 
    ☐ No 

Shape 

SECTION 3 — DIGESTION & GUT COMFORT 

  1. How often do you feel bloated? 
    ☐ Rarely 
    ☐ Sometimes 
    ☐ Often 

  1. How regular is your digestion? 
    ☐ Very regular 
    ☐ Mostly regular 
    ☐ Irregular 

  1. Do certain foods make you feel heavy or uncomfortable? 
    ☐ No 
    ☐ Sometimes 
    ☐ Often 

SECTION 4 — SKIN, HAIR & GLOW 

  1. How would you describe your skin? 
    ☐ Glowing 
    ☐ Balanced 
    ☐ Dry 
    ☐ Dull 
    ☐ Uneven 

  1. Are you looking to support natural collagen formation? 
    ☐ Yes 
    ☐ No 

  1. Are you noticing changes in hair strength or shine? 
    ☐ No 
    ☐ Mild changes 
    ☐ Significant changes 

SECTION 5 — HORMONAL BALANCE (40+) 

  1. Your age group: 
    ☐ Under 40 
    ☐ 40–50 
    ☐ 50+ 

  1. Are you experiencing mood or energy fluctuations? 
    ☐ Rarely 
    ☐ Sometimes 
    ☐ Often 

  1. Are you noticing changes in sleep, temperature, or rhythm? 
    ☐ No 
    ☐ Mild 
    ☐ Significant 

SECTION 6 — IMMUNE & SEASONAL WELLNESS 

  1. How often do you feel you need extra seasonal support? 
    ☐ Rarely 
    ☐ Sometimes 
    ☐ Often 

  1. Do you spend time outdoors regularly? 
    ☐ Yes 
    ☐ Sometimes 
    ☐ No 

SECTION 7 — LIFESTYLE & NUTRITION 

  1. How balanced are your meals? 
    ☐ Very balanced 
    ☐ Mostly balanced 
    ☐ Irregular 

  1. How would you describe your stress levels? 
    ☐ Low 
    ☐ Moderate 
    ☐ High 

  1. How active is your weekly routine? 
    ☐ Very active 
    ☐ Moderately active 
    ☐ Low activity 

 

END OF QUESTIONNAIRE 

Thank you for taking this moment for yourself. 
Your answers help us understand your rhythm so we can guide you toward the supplements that best support your energy, glow, digestion, balance, and long‑term vitality. 

Vitalitygrace.com

Back to blog