Family Survey Form 家庭问卷

1. How do you maintain your health? 请问你平时如何保养你的身体健康？
Daily Exercise 明天运动Taking Supplements 吃保健品None of the mentioned 两样都不是
 

2. Do you think medical bills are expensive nowsdays? 你认为目前的医药费会贵吗？
Yes 会No 不会
 

3. Do you think medicine really help you to recover from your sickness? 你认为生病吃药会好吗？
Yes 会No 不会
 

4. Have you heard about Live Cell Therapy? 你有听过活细胞疗法吗？
Yes 有No 没有
 

5. Would you be interested to find out more about Live Cell Therapy? 你想要详细了解什么是活细胞疗法吗？
Yes 想No 不想
 

6. Does any of your family members have these illnesses? 你有家人或亲人有以下的疾病吗？
- Diabetes 糖尿
- Hypertension 高血压
- Heart Disease 心脏病
- Asthma 哮喘病
- Back Pain 腰酸背痛
- Insomnia 失眠
- Stroke 中风
- Arthritis 关节炎
- Menstrual Disorders 经期失调
- Gout 痛风
- Cancer 癌症
- Allergies 过敏体质
- Kidney Disease 肾脏病
- Sciatica 坐骨神经痛
 
Yes 有No 没有

7. Would you be interested to know more if there is a food that can help these people to significantly improve on their conditions? 如果有一个食品可以完全让你家人或亲人改善这些病，你想了解多一点吗？
Yes 想No 不想

Your Name 姓名 (required)

Your Mobile Number 手机号码 (required)

Your Email 姓名 (required)