+ 64 (0)9 428 2931

The BE Cleanse Questionnaire

The BE Cleanse Questionnaire

This questionnaire helps us to assess whether it is right for you at this time to commence the  Balanced Energy Two Week Spring Cleanse or whether you may need more a specialised treatment, please complete thoroughly as this form will assist us with your particular health needs.

  • e.g. physical / mental / emotional / spiritual
  • e.g. to drugs, to foods, to environmental or chemical factors
  • e.g. vitamins, minerals, herbs, homoeopathics etc.

Statement from Balanced Energy

Thank you for filling in this assessment, as we are not doing an initial consultation with you before you begin your cleanse it contains important information for us to be able to assess whether it is appropriate for you to participate at this time. Once we receive this assessment back we will contact you to let you know more details about this guided cleanse.

While we take every precaution to ensure that this cleansing programme is healthy for you, we can take no responsibility for any event due to the fact that you have omitted to disclose important information to us about any specific health condition or needs that you may have.

If you have any concerns about your health at this time we recommend that you seek the advice of a qualified health professional or contact us for more detailed advice.

Warmest regards,

The Balanced Energy Team

Phone Now
Shop Now