AskDrLindsey.com

Warning: mysql_fetch_array(): supplied argument is not a valid MySQL result resource in /usr/home/askdrl/www/htdocs/copy.php on line 14
AskDrLindsey.com

Ask Dr. Lindsey

Genesis BOOST™ is pleased to offer you an individualized, detailed, health, nutrition, lifestyle and supplement program. It's provided by a nutritional consultant who collaborates with Dr. Lindsey Duncan, ND, CN, the creator of Genesis BOOST ™ Superfruit Supplements and Juices.

A $295 value, it's yours for only $25. You'll receive your own personal nutritional consultant dedicated to you throughout the entire process with unlimited follow-up consultations via phone and email.

Please complete the following questionnaire:

1. What is your main physical complaint or health issue?

2. What inherent weaknesses (genetics) run in your family history?

3. Please rate the following issues as they pertain to your health.

Questions	No problem	Low concern	Moderate concern	Serious problem

Mental clarity (forgetfulness, brain fog)

Stress level (daily, work, life stress)

Stress

Weight

Energy Levels

Sleep

Backaches & Joint Pains

Anxiety

Depression

Immune system (do you get sick easily?)

Digestion

4a. How many bowel movements are you having each day?

4b. Are they full and complete movements?

5. Describe the condition of your skin. Do you have normal skin or do you have problems with acne, wrinkles, dry skin, rashes or signs of premature aging?

6a. How many hours of sleep do you get each night?

6b. Do you wake up feeling rested?

7. How much alcohol do you consume each day, week or month?

8a. Do you use tobacco products?

8b. If yes, what kind and how often?

9a. How many times do you exercise each week?

9b. How long?

10. Do you have any other health-related issues, concerns or comments not yet covered?

Please enter your billing and payment information below. We guarantee that you are receiving the highest level of encryption possible. Your credit card account numbers and other confidential information cannot be intercepted or altered. The $25 processing fee will not be charged until your program is prepared.

Personal/Billing Information
Name: (as it appears on your credit card)
Nickname:
Address:
City:
State:
Province:
ZIP:
Country:
E-mail Address:
Verify E-mail Address:
Telephone Number:
Age:
Occupation:
Sex:	M F

If you have a valid promotion code,you do not need to enter credit card information

Promotional Code:
Credit Card Type:
Credit Card Number:
Expiration Date:
Security Code (CCV):

NOTE: If you would rather phone in your payment information, please call 1-888-323-9355. If you prefer to pay by check or money order, please make it out to Genesis Today for $25, write Ask Dr. Lindsey in the check/money order memo, and mail to:

Disclaimer
The information provided by Genesis Today and Lindsey Duncan ND, CN is not medical advice and is not intended to take the place of the care provided by your Medical Doctor. This information is provided for educational purposes only and the intention is to help educate on diet improvements, lifestyle improvements and nutritional supplementation. Genesis Today and Lindsey Duncan ND, CN do not treat, diagnose, prescribe for, or cure any disease, disorder, deformity or physical or mental condition. Because we are all so different, individual results may vary. Always consult your Doctor prior to starting any new health program.

Genesis Today
Attention: Ask Dr. Lindsey
14101 West Highway 290, Building 1900
Austin, TX 78737