Please answer the questionnaire below as honestly as possible for us to generate a more accurate DNA report for you.

1. What is your primary goal?
2. Are you regularly ill on a monthly basis?
3. Do you suffer from aches/pains on a monthly basis?
4. Do you have a certain time frame to achieve your goals?
5. Do you consider yourself active? Yes No
6. If yes, what is your effort level for your main source of activity? ?
   1 (Low intensity)

   Hardly any exertion and no effect on your breathing.

   2 - 3 (Light intensity)

   Feels like you can maintain for hours. Easy to breathe and carry a conversation.

   4 - 6 (Medium intensity)

   Breathing heavily, can hold a short conversation. Still somewhat comfortable, but becoming noticeably more challenging.

   7 - 8 (High intensity)

   Borderline uncomfortable, short of breath, can only speak a short sentence.

   9 - 10 (Very high)

   Very difficult to maximum effort. Can barely speak and cannot maintain for more than a short period of time.
7. Arrange in order the options that has the most impact in stopping you from being healthy and active. Starting from 1 as the most impactful to 5 as the least impactful, the number should not repeat.
   Free time

   1 2 3 4 5
   Work commitments

   1 2 3 4 5
   Diet

   1 2 3 4 5
   Motivation

   1 2 3 4 5
   Knowledge

   1 2 3 4 5
8. Do you consider yourself to have a healthy diet?
9. Do you regularly eat 5 portions of fruit or vegetables a day?
10. Do you take any vitamins and minerals on a daily basis?
11. Do you use any fitness supplements?
12. Do you drink at least 2.5/2 litres of water per day?
13. Do you regularly drink more than 2 cups of coffee a day?
14. Are you vegan?
15. Are you vegetarian?
16. Do you eat fish?
17. Do you omit any of the following foods?
18. Do you regularly consume alcohol?
19. Do you regularly smoke?
20. What do you consider your daily stress levels to be?
21. How much sleep do you regularly get a night?
22. Has your Dr/Physician ever said you should not exercise?
23. Have you had an injury affecting your muscles, ligaments, tendons and/or skeletal system in the past 12 weeks?
24. Are you pregnant?
25. Have you ever been diagnosed with any of the following conditions or do you know to have any condition that will prevent you from following any recommended exercise?
26. Which, if any, of the following statements applies to you? Please select all that apply.
27. Which of the following statements best describe your skin?

Please contact the number below to arrange your pick up.
Elken Brunei Office
Tel: +673 223 6127

Please drop off your test kit at one of the locations below.
Brunei Branch
Block B, Unit 6, 7 & 8,
Setia Kenangan 2, Spg 150-5-13-18,
Jalan Jame'Asr Kg Kiarong,
Mukim Gadong B BE 1318,
Brunei Darrussalam
Tel: +673 223 6127
Fax: +673 223 6130
EDD: +673 223 6131