Part 1/2 Personal particulars

What is your name?

When is your birthday?

What is your gender?

What is your email address?



We will deliver your CHARGE-UP® recommendation to this email address.
Your personal data is safe with us!
Part 2/2 Mental wellness assessment

From a scale of 1 to 10:

How is your stress level?

How do you feel most of the time?

Do you experience any of these
when you’re stressed out?

You may choose more than one option.

Do you sleep well?

Do you experience racing thoughts
before sleep?

Racing thoughts are often symptoms associated to anxiety.

Do you have trouble focusing or
concentrating on tasks?

Do you experience any of these symptoms
related to brain fog?

You may choose more than one option.

Do you experience any of these symptoms
related to short-term memory?

You may choose more than one option.

Thanks !

Hold on while we prepare your CHARGE-UP® recommendations

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