Zdraví Online – products & system of STARLIFE®

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+420 737 252 404, -405
objednavky@zdravi.online

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Fill in the questionnaire, please.
The questionnaire serves for a right determination of an appropriate and efficient product combination,
the document is not being filed anywhere and is not to be used for any other purposes. Your enquiry will be processed
by STARLIFE Medical Council, then you will receive an e-mail (on the address you state below) with an appropriate answer.
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Enquiry:*

Letters remaining:
 
Personal data
yes no
 
Lifestyle
 Diet
× daily
litres/daily
yes no
 Body weight
kg
kg
yes no
 Food composition
 Physical activity
× daily
 Habits
Pcs/daily
years
× weekly
 Others
hours
yes no
yes no
 
Do you suffer from any of following problems?
A. Cell malnourishment stadium
hair falling
light tiredness, bags under the eyes
nail refractivity, structural changes on nails
light headache
fine wrinkles (eyes, lips, cheeks)
B. Serious cell malnourishment stadium
strong headache, migraines
weak immunity, chronic cold, allergy
thyroid
anemia
bronchi, rhinopharynx, asthma
lungs, respiratory problems
heart
digestive problems, flatulence, heartburn, stomach ulcers
gall bladder
pancreas
chronic tiredness
overweight or underweight
quality of veins, varices
varicose ulcers
feet, hands swellings
pregnancy
kidneys
liver
urinary tract
prostate
gynecological problems, female organs
irregular stool, tendency to constipation
diabetes
cholesterol
eczema, psoriasis
mental problems, nervousness, depression
pains in spine (cervical, hipster)
pains in joints, rheumatism, arthrosis, arthritis
osteoporosis, osteopenia
high blood pressure
low blood pressure
C. Serious cell malnourishment stadium
heart stroke
apoplectic stroke
tumour
cyst, myoma
other problems:
D. Usage of medicaments for blood thinning, other medicaments or food supplements
 
               

Privacy statement

By filling in the form on the www.starlife.eu site, you are giving your personal information according to the law No. 101/2000 Coll., on personal data protection to company Zdraví Online s.r.o., which operates www.starlife.eu.

Zdraví Online s.r.o. handles the personal data of the people that are registered through the website www.starlife.eu, as well as all data obtained from questioning or surveys, and that for an indefinite period, to the appeal of the consent of each registered person. Zdraví Online s.r.o. hereby declares that all the information obtained be considered highly confidential and uses it only for their own use within the meaning of Act No. 101/2000 Coll. on the protection of personal data, to improve their services and for marketing purposes of the company Zdraví Online s.r.o.

The person providing the information notes that its approval may at any time be writtenly revoked. Your personal information will not be disclosed to others without your consent. On the explicit request your personal information from the database of Zdraví Online will be erased.

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