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Analyzing Your Pain…

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Welcome to ProleevaMax

Your Journey to Wellness Starts Here.

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What is your name?*

First Last

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What is your email address?*

Consent

Special offers and updates? Count me in!

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How do you identify?

Male

Female

Non Binary

I Prefer Not To Say

How old are you?

18-29

30s

40s

50s

60+

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Studies Show that Women are More Likely to Suffer from Chronic Pain

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How often do you exercise?

Everyday

A Few Days a Week

Once a Week

Never

Have you tried an anti-inflammatory diet?

Yes

No

I Don't Know

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Chronic Inflammation is at the Core of Chronic Pain

Studies have show that an anti-inflammatory diet can help ease fibromyalgia and chronic pain symptoms. - Cleveland Clinic

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Do you suffer from a Chronic Illness?

Select all that apply:

No

Yes - Arthritis

Yes - Fibromyalgia

Yes - Diabetic Neuropathy

Yes - Other

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Proleeva Fills Nutrient Gaps Involved with Chronic Illnesses

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What factors contribute to your chronic pain?

Select all that apply:

Disease

Physical Injury

Post-Surgery

Hereditary Disease/Genetics

Sports Related Injury

On average, how severe is your chronic pain?

High

Medium

Low

Unsure

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You’re Doing Great!

Learning about your pain is the first step in finding relief.

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How long have you had chronic pain?

A Few Months

More Than a Year

Several Years

Longer Than I Can Remember

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You're Not Alone.

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Does your chronic pain effect your everyday life?

Yes

No

Sometimes

In what way does it impact your everyday life?

Select all that apply:

Less Productivity

Fatigue & Low Energy

Keeps You From Doing More

Depression & Anxiety

Weight Gain

Isolation

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Does chronic pain keep you up at night?

Yes, All The Time

Sometimes

Rarely

Never

Do you often stay at home because of chronic pain?

Yes, All The Time

Sometimes

Rarely

Never

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Did you Know Lack of Sleep Affects Productivity?

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How much work do you miss per year because of chronic pain?

None

A Few Days

1-2 Weeks

More

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Are you taking any prescription medication for pain?

Yes

No

Are you satisfied with your current pain management plan?

Yes

No

I Don't Know

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Opioids are Potentially Addictive

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Pain relief with natural remedies generally take time. How much time are you willing to invest in yourself for a pain-free future?

However Long It Takes

A Few Months

A Few Weeks

I Don't Want to Invest

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Everyone has Different Condition Stages & Severities

ProleevaMax starts to work right away, but it will take time to have noticeable effects - especially if you have an illness that is more advanced, and you are experiencing major pain.

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How did you hear about ProleevaMax Nutraceutical?

Instagram

Google

TikTok

Blog or Article

Family or Friend

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Email

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